| NPI | 1174229959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LEE COO 732-207-1689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-02-03 |
| Last Update Date | 2024-02-29 |