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General NPI Number Information
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NPI Number | 1679592752
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Entity Type | Organization
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Legal Business Name | MOUNIR MADY DMD PA
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 09/22/2008
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Provider Practice Location Address
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Address Line | 930 SPRING VALLEY RD
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City | MAYWOOD
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State | NJ
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Zip | 07607-1436
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Country | US
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Telephone | 201-843-3312
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Fax | 201-843-1818
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Provider Business Mailing Address
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Address Line | 930 SPRING VALLEY RD
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City | MAYWOOD
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State | NJ
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Zip | 07607-1436
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Country | US
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Telephone | 201-843-3312
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Fax | 201-843-1818
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOUNIR H MADY
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Credential | DMD
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Telephone | 201-843-3312
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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 | 9946
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License Number State | NJ
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