| NPI | 1174685713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER MIKHAILOV Owner 973-812-4266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 19779) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |