| NPI | 1629500715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN MAHER Licensing Coordinator 973-598-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02441400) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |