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Individual

DR. KATELYN MICHELLE DOMINGUES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
59 E MILL RD STE 2-2304, LONG VALLEY, NJ 07853-6215
(908) 876-5225
(908) 876-1062
Mailing address
59 E MILL RD STE 2-2304, LONG VALLEY, NJ 07853-6215
(908) 876-5225
(908) 876-1062

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02672401
NJ
390200000X
Student in an Organized Health Care Education/Training Program
NJ

Other

Enumeration date
04/26/2016
Last updated
07/21/2022
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