Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 248768 | NJ |
NPI | 1093358301 |
---|---|
Provider Name | Sarah Theresa Faleris |
First Address | Millville, NJ 08332-6129 |
Second Address | Cape May Court House, NJ 08210-1613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2019 |
Last Update Date | 21/10/2019 |