| NPI | 1386846459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CONWAY DIAZ Secretary Treasurer 609-601-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DI018824) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |