| NPI | 1023192499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN SAMUEL FORMAN President 732-356-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NJ 011442) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |