| NPI | 1609253582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG DRUT Owner 201-308-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NJ 047218-1) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2015-04-30 |