| NPI | 1215131172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH ELAINE PARKIN EDWIN Owner 973-743-4743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ di123123) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ di02147100) |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NJ dio2172300) | |
| 1223P0300X Dentist, Periodontics (Licence: NJ di20510) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-22 |