Individual
DR. MEDINA DIANA DADURIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
2 SEARS DRIVE, SUITE 102, PARAMUS, NJ 07652
(201) 791-4113
(201) 791-2512
Mailing address
2 SEARS DRIVE, SUTIE 102, PARAMUS, NJ 07652
(201) 791-4113
(201) 265-5418
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
4081
NJ
1223P0221X
Pediatric Dentistry
Primary
DI017957
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7989
DELTA DENTAL
NJ
Enumeration date
09/27/2006
Last updated
04/09/2012
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