| NPI | 1164618435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID Z EVDOKIMOW Owner 908-221-1136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 25MA07315300) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NJ 25MA07315300) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NJ 25MA07315300) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2008-04-03 |