| NPI | 1306922422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE A NIEBLOOM Doctor VP 973-736-7616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2016-10-05 |