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General NPI Number Information
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NPI Number | 1356540280
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Entity Type | Individual
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Provider Name | SHARON KNOLL DMD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 149 W ENGLEWOOD AVE
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City | TEANECK
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State | NJ
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Zip | 07666-5015
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Country | US
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Telephone | 201-837-3322
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Fax |
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Provider Business Mailing Address
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Address Line | 554 GRENVILLE AVE
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City | TEANECK
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State | NJ
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Zip | 07666-2121
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Country | US
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Telephone | 201-530-9583
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Fax | 201-836-2051
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DI21291
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License Number State | NJ
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