| NPI | 1164964169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERI IRVING Member 856-270-2373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02219204) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2016-11-08 |