Individual
DIVYA JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 SAINT GEORGES AVE, AVENEL, NJ 07001-1390
(732) 910-7286
Mailing address
30 WATERSIDE PLZ APT 12G, NEW YORK, NY 10010-2644
(732) 910-7286
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02915700
NJ
Other
Enumeration date
04/19/2022
Last updated
07/26/2022
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