| NPI | 1184054645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MARIN Manager 917-561-7256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02454300) |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2013-11-20 |