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General NPI Number Information
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NPI Number | 1922660257
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Entity Type | Individual
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Provider Name | DR. PHOEBE FAM HARTELL
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Gender | Female
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 103 CARNEGIE CTR STE 300
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City | PRINCETON
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State | NJ
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Zip | 08540-6235
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Country | US
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Telephone | 888-964-6681
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Fax |
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Provider Business Mailing Address
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Address Line | 6 MOUNTAIN TOP TER
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City | LITTLE FALLS
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State | NJ
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Zip | 07424-2058
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Country | US
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Telephone | 347-581-4377
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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 | 22
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License Number State | NJ
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