| NPI | 1326251307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY ROBERT BLOOM Partner 732-968-0086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 14553) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NJ 14553) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |