Individual
DR. NANCY DIAMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1275 15TH ST APT LE, FORT LEE, NJ 07024-1906
(201) 123-4567
Mailing address
1275 15TH ST APT LE, FORT LEE, NJ 07024-1906
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
039397
NY
1223G0001X
General Practice Dentistry
Primary
DI01527500
NJ
Other
Enumeration date
08/01/2006
Last updated
03/07/2014
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