| NPI | 1215103841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC SIMON Dentist 973-881-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DIO1100900) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NJ 22DIO1125900) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DIO2197800) | |
| Enumeration Date | 2008-05-04 |
| Last Update Date | 2008-05-04 |