| NPI | 1346995834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRES JIMENEZ WOLF Owner 732-409-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2022-02-14 |