| NPI | 1437305463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELDON WALTUCH Owner 732-549-6286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2008-08-11 |