Individual
MORDECHAI FRIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
67 STATE ROUTE 36, WEST LONG BRANCH, NJ 07764-1432
(848) 228-2583
Mailing address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(215) 456-6620
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI02952800
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2020
Last updated
07/25/2025
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