| NPI | 1396839155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MCDONOUGH Owner 609-730-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ DI18916) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |