| NPI | 1639471758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVI WEISFOGEL President 732-261-2859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DI20783) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NJ DI20783) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2011-04-05 |