| NPI | 1528110814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY KOSLOW Owner 856-845-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 12612) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 10013) |
| 1223G0001X Dentist, General Practice (Licence: NJ 21261) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2008-07-30 |