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Individual

ELIZABETH CLANAMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17 SUMMIT AVE, HACKENSACK, NJ 07601-1218
(201) 996-0770
Mailing address
3630 DAYLILLY WAY, HUNTINGDON VALLEY, PA 19006-7766
(215) 200-0474

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI02850400
NJ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/02/2019
Last updated
07/14/2021
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