| NPI | 1477412062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN JOSEPH SUBTELNY Managing Member 201-509-5648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2026-01-19 |
| Last Update Date | 2026-04-22 |