| NPI | 1336630599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN FRANK BOGART Co Owner 908-852-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 22DI01712700) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 22DI02405804) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |