Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DS040335 | PA |
Y | 1223P0221X | Pediatric Dentist | DS040335 | PA |
NPI | 1104246404 |
---|---|
Provider Name | Sara Toema |
First Address | Cherry Hill, NJ 08003-4956 |
Second Address | Cherry Hill, NJ 08003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2014 |
Last Update Date | 29/06/2018 |