| NPI | 1073066700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA PETROLITO Office Mgr 732-477-5770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 9440) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 9434) |
| 1223G0001X Dentist, General Practice (Licence: NJ 21211) | |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2016-07-29 |