Individual
DR. NORACHAI PHISUTHIKUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
110 BERGEN ST, ROOM C781, NEWARK, NJ 07103-2495
(973) 972-4210
Mailing address
9 ROYAL COURT DR APT J20, SPRING LAKE, NJ 07762-2324
(646) 246-1978
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02345400
NJ
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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