Individual
OLIVIA ISSHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
991 VAN HOUTEN AVE, CLIFTON, NJ 07013-2643
(201) 895-0647
Mailing address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-5635
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02855100
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2021
Last updated
01/12/2023
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