| NPI | 1033484654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHAN HERNANDEZ President 551-265-5248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02411100) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2012-03-14 |