Individual
ALISSA SELEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
803 KENNEDY BLVD, BAYONNE, NJ 07002-5835
(201) 339-6604
Mailing address
803 KENNEDY BLVD, BAYONNE, NJ 07002-5835
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
056383
NY
122300000X
Dentist
Primary
22DI02503900
NJ
Other
Enumeration date
06/29/2012
Last updated
12/21/2021
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