Individual
DR. MARIAM BESHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
222 HALEDON AVE, PROSPECT PARK, NJ 07508-2024
(973) 652-3093
Mailing address
126 HOPPER AVENUE, NUTLEY, NJ 07110
(973) 652-3093
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02687600
NJ
122300000X
Dentist
Primary
PENDING
NJ
Other
Enumeration date
06/18/2017
Last updated
03/17/2018
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