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General NPI Number Information
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NPI Number | 1023839206
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Entity Type | Organization
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Legal Business Name | SUNFLOWER DENTAL GROUP OF WESTWOOD PC
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 316 KINDERKAMACK RD UNIT C
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City | WESTWOOD
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State | NJ
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Zip | 07675-1635
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Country | US
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Telephone | 201-497-6532
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Fax | 201-488-1137
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Provider Business Mailing Address
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Address Line | 139 SAND RD
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City | WESTWOOD
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State | NJ
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Zip | 07675-2419
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Country | US
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Telephone | 201-965-0087
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Fax |
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Authorized Official
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Title or Position | OWNER/GENERAL DENTIST
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Name | DR. MARYAM JAHANSOUZ
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Credential | D.D.S.
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Telephone | 201-497-6532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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