Willowbrook Mall Dental, PA
NPI #1174685713 in Wayne, New Jersey
Provider Information
- NPI Number
- 1174685713
- Entity Type
- Organization
- Organization Name
- Willowbrook Mall Dental, PA
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 13, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1445 WILLOWBROOK BLVD
- City
- Wayne
- State
- New Jersey
- ZIP Code
- 07470
- Phone
- (973) 812-4426
Authorized Official
- Name
- DR. ALEXANDER MIKHAILOV
- Title
- OWNER
- Phone
- (973) 812-4266
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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