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Individual

ELLA KOROBOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
473 BROADWAY, SUITE 200, BAYONNE, NJ 07002-3697
(201) 339-7275
(201) 339-0801
Mailing address
5A ORCHARD ST, MILLBURN, NJ 07041-1109
(201) 339-7275
(201) 339-0801

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI02201
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9052909
NJ
Enumeration date
04/14/2007
Last updated
07/09/2007
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