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General NPI Number Information
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NPI Number | 1275357741
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Entity Type | Individual
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Provider Name | SARA M. EZZAT DMD
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Gender | Female
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1861 ROUTE 130
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-3026
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Country | US
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Telephone | 732-508-0234
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Fax |
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Provider Business Mailing Address
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Address Line | 1861 ROUTE 130
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-3026
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Country | US
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Telephone | 732-690-1352
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 22DI03047600
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License Number State | NJ
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