Sultan Sherzoy

Individual provider Active NPI General Practice Dentistry · Bogota, NJ

NPI 1609933506 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1609933506
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
18259 (NJ)
Practice address
85 E Main St
Bogota, NJ 07603
Phone
(201) 343-6770
Fax
(201) 343-6704
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
18259NJMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18259 NJ Yes

Addresses

Primary practice location

85 E Main St
Bogota, NJ 07603

Mailing address

85 E Main St
Bogota, NJ 07603
Phone (201) 343-6770

Other providers in Bogota, NJ

All providers in Bogota, NJ · General Practice Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.