| NPI | 1336506849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH S HOOVER Owner 609-953-7199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 16152) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: 16511) |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2016-01-28 |