| NPI | 1063671196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL M SANDMAN Orthodontist 201-792-7666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02309200) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2008-06-04 |