Provider Demographics
NPI:1730467374
Name:JAFFERY, FIZZA AFTAB (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:FIZZA
Middle Name:AFTAB
Last Name:JAFFERY
Suffix:
Gender:F
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 UNION MILL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6299
Mailing Address - Country:US
Mailing Address - Phone:856-437-5225
Mailing Address - Fax:
Practice Address - Street 1:115 UNION MILL RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-6299
Practice Address - Country:US
Practice Address - Phone:856-437-5225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038135122300000X, 1223S0112X
PAMT200006208600000X
NJ22DI025740001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No208600000XAllopathic & Osteopathic PhysiciansSurgery