Individual
DR. NIMA MIR MADJLESSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS,MSD,PA
Contact information
Practice address
E7 BRIER HILL CT, EAST BRUNSWICK, NJ 08816-3336
(732) 651-8470
(732) 651-8033
Mailing address
E7 BRIER HILL CT, EAST BRUNSWICK, NJ 08816-3336
(732) 651-8470
(732) 651-8033
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
20508
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710151089
—
NJ
Enumeration date
07/06/2006
Last updated
02/17/2012
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