| NPI | 1205295755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA GOLDBERG Owner 862-219-5625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI01949000) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-02-12 |