| NPI | 1073696373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER JOHN ANTONELLIS President 973-227-1132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NJ 13056) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2008-08-05 |