| NPI | 1689792715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA P REED Treasurer 856-857-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI019194) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ DI019404) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |