| NPI | 1003264326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD REBHUN Owner 856-772-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery (Licence: NJ 12708) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2019-08-27 |