Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 22D102597300 | NJ |
NPI | 1043658453 |
---|---|
Provider Name | Ms. Smita S Lad |
First Address | Princeton, NJ 08540-2757 |
Second Address | Princeton, NJ 08540-2757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 20/06/2016 |