| NPI | 1164850327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FRATTELLONE Oral Surgeon/Owner 732-842-5915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 16514) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 25066) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 25371) | |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2013-10-28 |