| NPI | 1033395934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY LAURENCE JACOBSON Owner 201-837-1612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NJ DI19069) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2008-01-10 |