| NPI | 1154910412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISHITA IRUKULLA President 609-233-6672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223P0700X Dentist, Prosthodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-14 |