| NPI | 1104328772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRATHIMA NERUGANTI Sole Owner 908-285-5515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NJ 22D102299300) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |