Provider Demographics
NPI:1497945604
Name:SEGAL AND IYER ORTHODONTICS
Entity Type:Organization
Organization Name:SEGAL AND IYER ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MONISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:IYER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-810-1006
Mailing Address - Street 1:501 ROUTE 73 SO AND BRICK RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-810-1006
Mailing Address - Fax:856-810-1007
Practice Address - Street 1:501 ROUTE 73 SO AND BRICK RD
Practice Address - Street 2:SUITE 202
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-810-1006
Practice Address - Fax:856-810-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D102071880122300000X
NJ22D102226700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty