| NPI | 1174587836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE J. DIERNA Treasurer 732-671-1266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2011-10-17 |