Individual
AVI ISRAELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1520 ROUTE 138, WALL, NJ 07719-3706
(732) 528-6007
Mailing address
1520 ROUTE 138, WALL, NJ 07719-3706
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22212
NJ
Other
Enumeration date
04/10/2006
Last updated
06/27/2012
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