Organization
LIV ENDODONTICS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASSIM KOHLY ADS (DR)
(347) 989-6103
Entity
Organization
Contact information
Practice address
22 OLD SHORT HILLS RD STE 208, LIVINGSTON, NJ 07039-5605
(347) 989-6103
Mailing address
22 OLD SHORT HILLS RD, LIVINGSTON, NJ 07039-5604
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114448941
NA
NY
Enumeration date
01/23/2022
Last updated
01/23/2022
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