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General NPI Number Information
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NPI Number | 1740015874
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Entity Type | Organization
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Legal Business Name | BARAZESH ILLIANO DENTAL PARTNERSHIP
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Dates
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Enumeration Date | 09/06/2024
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 2435 LAMINGTON RD
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City | BEDMINSTER
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State | NJ
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Zip | 07921-2993
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Country | US
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Telephone | 908-500-4921
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Fax |
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Provider Business Mailing Address
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Address Line | 274 N MAPLE AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1024
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Country | US
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Telephone | 908-500-4921
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | SARA BARAZESH
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Credential | DDS
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Telephone | 908-500-4921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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