Individual
ANGELA LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
65 JAMES ST, EDISON, NJ 08820-3903
(732) 321-7608
Mailing address
44 BAYBERRY CLOSE, PISCATAWAY, NJ 08854-5924
(732) 853-2701
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02801300
NJ
122300000X
Dentist
22DR03426
NJ
Other
Enumeration date
07/04/2019
Last updated
08/30/2020
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