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Individual

MR. MARWAN M JALLAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
14 DOSCHER AVENUE, WEST NYACK, NY 10994
(845) 727-4124
(845) 727-4128
Mailing address
14 DOSCHER AVENUE, WEST NYACK, NY 10994
(845) 727-4124
(845) 727-4128

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
043263
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01283421
NY
Enumeration date
01/24/2007
Last updated
09/11/2007
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