| NPI | 1205944733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JOHN MARCUCCI Owner President Dentist 856-697-2440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI01342700) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS020230L) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |