| NPI | 1598546897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILDA PENA TEJADA Doctor/Authorized Official 201-865-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-10-16 |