| NPI | 1285872515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRILL FAY Owner 973-714-1863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: NY 052966) |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2015-04-16 |