| NPI | 1700950862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY NICHOLAS DICESARE President 732-747-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI00812601) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 0247531) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |