Individual
BADR RAISSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
107 CEDAR GROVE LN STE 102, SOMERSET, NJ 08873-4719
(732) 357-3770
Mailing address
832 WILLOW AVE APT 3D, HOBOKEN, NJ 07030-2906
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02787200
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2019
Last updated
01/11/2021
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