| NPI | 1619104015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD L GAINES Ower 732-367-4042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ DI09103) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2009-06-12 |