| NPI | 1417083106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA SHELTON Manager 973-621-6678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: NJ 08689) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2007-09-25 |