Organization
AM GHANEM DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIA WILLIAMS (PROVIDER ENROLLMENT TEAM LEAD)
(315) 454-6000
Entity
Organization
Contact information
Practice address
1030 WEST EDGAR RD, STE B, LINDEN, NJ 07036
(908) 545-3031
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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