| NPI | 1578000196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENI GLAVICIC Co Owner 201-945-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI16680) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ DI17286) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |