| NPI | 1295814051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD G LISMAN Credentialing Coordinator 908-387-6120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-08-22 |