| NPI | 1063867117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SANDOVAL Owner 973-338-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053693-1) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |