| NPI | 1699630954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN LIGHT Owner 201-509-0737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-12-18 |
| Last Update Date | 2026-03-02 |