| NPI | 1154769750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRINA KAZBANOV President 201-585-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: NJ 22DI02479500) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2013-06-05 |