| NPI | 1043748767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISA VELAZQUEZ Partner 732-473-1123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2017-05-25 |