Individual
DR. SAMUEL J MUTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
308 TUCKERTON ROAD, MEDFORD, NJ 08055
(609) 654-2454
(609) 654-6568
Mailing address
308 TUCKERTON ROAD, MEDFORD, NJ 08055
(609) 654-2454
(609) 654-6568
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18508
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7585306
—
NJ
Enumeration date
01/10/2007
Last updated
07/08/2007
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