| NPI | 1629316054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE NEBBLETT Orthodontist 732-462-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02272100) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02223194) |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2017-01-23 |