| NPI | 1669911475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA N GALLUCCI Dentist/Owner 856-983-0546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2022-08-11 |