Individual
DARIYA MOMOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 S MAIN RD, B4, VINELAND, NJ 08360-7897
(856) 691-0290
Mailing address
1601 SPRING GARDEN ST, SUITE 412, PHILADELPHIA, PA 19130-3940
(917) 868-4541
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02610200
NJ
Other
Enumeration date
07/31/2015
Last updated
07/31/2015
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