| NPI | 1659086049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN RICE Credentialing Manager 609-315-3851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2023-06-28 |