| NPI | 1558306415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A VITALE President 732-494-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 220I01684700) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 220I01414100) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-08-22 |