| NPI | 1245697432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD KOZLOVSKY Owner 732-671-5822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 22D102185305) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2016-04-08 |