| NPI | 1265644579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MATUS Office Manager 973-729-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ DI08978) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NJ DI20516) |
| 1223G0001X Dentist General Practice (Licence: NJ DI18055) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |