| NPI | 1063627289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LITTLE Member 732-449-6564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NJ 812501) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |