| NPI | 1154860252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A MAHER Licensing Coordinator 973-598-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02505301) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-03-29 |