| NPI | 1285825760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN A LEIVA Orthodontist/Owner 609-409-0499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ DI017000) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-08-08 |