Individual
DR. SEBU IDICULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5 SICOMAC RD, SUITE 12, NORTH HALEDON, NJ 07508-2972
(973) 423-3399
(973) 423-4828
Mailing address
5 SICOMAC RD, SUITE 12, NORTH HALEDON, NJ 07508-2972
(973) 423-3399
(973) 423-4828
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02241500
NJ
Other
Enumeration date
11/28/2006
Last updated
04/19/2011
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