Individual
DR. MOULI SURTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
381 CHESTNUT ST, UNION, NJ 07083-9430
(908) 686-2082
(908) 686-2149
Mailing address
55 RIVERWALK PLACE, APT 703, WEST NEW YORK, NJ 07093
(908) 686-2082
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI02541300
NJ
Other
Enumeration date
03/15/2012
Last updated
07/21/2022
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