| NPI | 1043731490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE D BAALS Director Of Operations 856-381-7196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS019098L) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2022-07-21 |