Individual provider · NPI-1

Dr. Jonathan Mangot, DMD

Dentist, General Practice · Waldwick, NJ

NPI number1093871295
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1093871295
Entity type
Individual (NPI-1)
Name
Dr. Jonathan Mangot
Credential
DMD
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 29, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice16135NJYes

Practice location

61 Crescent Ave
Waldwick, NJ 07463-1431

Phone 210-445-1441 · Fax 201-445-1484

Mailing address

405 Pine Ln
Haworth, NJ 07641-1308

Phone 201-385-2635 · Fax 201-244-5381

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dentist, General Practice providers in Waldwick, NJ