| NPI | 1568902807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG DRUT Owner 201-308-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 02070700) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |