| NPI | 1184772188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN GROBER Director 908-964-5406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 20813) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 10967) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |