| NPI | 1376926618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON RAINES Owner 908-770-1506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02500500) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2015-07-06 |