Individual
TALIA MIRIAM STONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 GODWIN AVE STE 2, WYCKOFF, NJ 07481-2099
(732) 606-6842
Mailing address
149 SUSSEX RD, BERGENFIELD, NJ 07621-4030
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI02869700
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2020
Last updated
06/17/2022
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