| NPI | 1255642062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LON J ROSEN Sole Member 201-960-5790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI01439000) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |