Individual
MARYAM MANOUCHEHRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1130 BLACKWOOD CLEMENTON RD, PINE HILL, NJ 08021-6965
(856) 627-2400
(856) 783-2798
Mailing address
1130 BLACKWOOD CLEMENTON RD, PINE HILL, NJ 08021-6965
(856) 627-2400
(856) 783-2798
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20691
NJ
Other
Enumeration date
11/01/2006
Last updated
06/14/2010
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