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Individual

DR. PAVITRA BANAV

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
149 MAIN ST APT 2A, MILLBURN, NJ 07041-1149
(732) 829-5829
Mailing address
149 MAIN ST APT 2A, MILLBURN, NJ 07041-1149

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02557000
NJ

Other

Enumeration date
04/10/2014
Last updated
04/10/2014
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