Individual
MAGNOLIA M PELAEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1301 ATLANTIC AVE, ATLANTIC CITY, NJ 08401-7247
(609) 572-0000
(609) 567-0039
Mailing address
860 S WHITE HORSE PIKE, HAMMONTON, NJ 08037-2018
(609) 567-0200
(609) 704-1482
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI01796300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0120278
—
NJ
Enumeration date
04/11/2006
Last updated
07/11/2007
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