| NPI | 1154011575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO ANN RICE Credentialing Director 609-315-3851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-05-09 |