| NPI | 1649300500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON C CHANG Dentist 732-777-0660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI02039500) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2011-09-06 |