| NPI | 1073767281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MAY BACKHAUS Owner/ Pediatric Dentist 732-257-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02292000) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02295100) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2008-11-14 |