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Individual

DR. DIANA SUZANNE POLK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
11 N BEVERWYCK RD, LAKE HIAWATHA, NJ 07034-2518
(973) 334-0212
Mailing address
11 N BEVERWYCK RD, LAKE HIAWATHA, NJ 07034-2518

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI01879100
NJ

Other

Enumeration date
08/14/2007
Last updated
08/14/2007
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