Individual
HUSHAM A EDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTIST
Contact information
Practice address
110 BERGEN ST, NEWARK, NJ 07103-2495
(973) 972-6350
Mailing address
110 BERGEN ST, NEWARK, NJ 07103-2495
(973) 972-6350
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02838900
NJ
1223P0300X
Periodontics
06960
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/08/2018
Last updated
06/29/2021
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