| NPI | 1043272040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARD L. GONSALVES Owner 973-763-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DI01640700) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2020-08-22 |