Organization
MONMOUTH MALL DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER MIKHAILOV DDS (PRESIDENT)
(201) 626-2500
Entity
Organization
Contact information
Practice address
180 ROUTE 35 S, EATONTOWN, NJ 07724-2023
(201) 626-2500
Mailing address
180 ROUTE 35 S, EATONTOWN, NJ 07724-2023
(201) 626-2500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19779
NJ
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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