| NPI | 1225676018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOELLE ROTONDA Credentialing Manager 732-451-2734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2019-12-12 |