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 |