| NPI | 1154443026 |
|---|---|
| Other Name | LLC |
| Entity Type | Organization |
| Authorized Contact | MITCHELL BRUDNO Owner Sole Member LLC 856-429-4249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ NJDI15818) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |