| NPI | 1457641334 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | AVI WEISFOGEL President 732-257-5600  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DI20783)  | 
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NJ DI20783)  | 
| Enumeration Date | 2011-04-13 | 
| Last Update Date | 2011-04-13 |