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General NPI Number Information
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NPI Number | 1841424496
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Entity Type | Individual
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Provider Name | MONA OMRAN DDS
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Gender | Female
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 1075 CENTRAL PARK AVE. SUITE 104
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City | SCARSDALE
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State | NY
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Zip | 10583
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Country | US
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Telephone | 914-472-9400
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Fax | 914-723-1160
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Provider Business Mailing Address
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Address Line | 1075 CENTRAL PARK AVE SUITE 104
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City | SCARSDALE
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State | NY
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Zip | 10583-3242
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Country | US
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Telephone | 856-906-1578
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 010131
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License Number State | CT
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