| NPI | 1457680225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LEE SCHUPPER VP 856-309-2244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI01705400) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2009-12-08 |