Individual
MEGA MANCHANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
170 MAIN ST, UNITS 109-110, LODI, NJ 07644
(201) 397-1420
Mailing address
345 E 24TH ST, NEW YORK, NY 10010-4020
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI02974600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/17/2018
Last updated
09/11/2023
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