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General NPI Number Information
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NPI Number | 1043402027
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Entity Type | Organization
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Legal Business Name | ISAI FISHKIN D.D.S.,PA
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 213 SUMMIT RD
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092-2316
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Country | US
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Telephone | 908-654-7979
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Fax | 908-654-9444
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Provider Business Mailing Address
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Address Line | 213 SUMMIT RD
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092-2316
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Country | US
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Telephone | 908-654-7979
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ISAI FISHKIN
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Credential | DDS
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Telephone | 908-654-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DI15341
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License Number State | NJ
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