Individual
DR. FARIBA EDALAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
639 MOUNT PROSPECT AVE, NEWARK, NJ 07104-3109
(973) 481-3900
(973) 481-2999
Mailing address
29 SCHINDLER TER, WEST ORANGE, NJ 07052-1079
(973) 736-0642
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI22496
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0233552
—
NJ
Enumeration date
02/17/2010
Last updated
09/06/2012
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