| NPI | 1184789125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEUGENY AUDEYCHIK Dentist 973-372-7049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 19161) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 19119) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2013-05-07 |