NPI | 1609954064 |
---|---|
Entity Type | Organization |
Authorized Contact | LARISA ILYUTOVICH President Owner 201-346-4660 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DI020299) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2020-08-22 |