| NPI | 1518115377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC DAVID STEIN Owner 856-696-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ NJ11102) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NJ 2068) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2008-09-05 |