Individual
DR. EVAN SPIVACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
NJDS-UMDNJ, 110 BERGEN ST, NEWARK, NJ 07103
(973) 972-7040
Mailing address
911 ALPINE DR, TEANECK, NJ 07666-5542
(201) 833-4246
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI 20113
NJ
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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