| NPI | 1295920098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS MICHAEL KELLER Owner 732-566-3111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 09859) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2008-09-11 |