Provider Demographics
NPI:1396759155
Name:SADIQ, ISABELLA (DDS)
Entity type:Individual
Prefix:DR
First Name:ISABELLA
Middle Name:
Last Name:SADIQ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:AMINA
Other - Middle Name:
Other - Last Name:SADIQ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1202 ROUTE 73
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2214
Mailing Address - Country:US
Mailing Address - Phone:856-222-1100
Mailing Address - Fax:856-222-4180
Practice Address - Street 1:1202 ROUTE 73
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2214
Practice Address - Country:US
Practice Address - Phone:856-222-1100
Practice Address - Fax:856-222-4180
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ173091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice