| NPI | 1104949064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PAUL DOUGHERTY President 973-377-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ D15205) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2020-08-22 |