| NPI | 1255070025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA STAVISKY Owner 609-405-0541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-05-31 |