Provider Demographics
NPI:1649398652
Name:SEBASTIAN, MARIA VICTORIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:VICTORIA
Last Name:SEBASTIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 E NORTHFIELD RD STE 211
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4806
Mailing Address - Country:US
Mailing Address - Phone:973-740-9200
Mailing Address - Fax:973-740-9215
Practice Address - Street 1:349 E NORTHFIELD RD STE 211
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4806
Practice Address - Country:US
Practice Address - Phone:973-740-9200
Practice Address - Fax:973-740-9215
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI197361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice