| NPI | 1730305640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANIE A TILTON Office Manager 856-582-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI23083) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ DI19807) |
| 122300000X Dentist (Licence: NJ DI11620) | |
| 122300000X Dentist (Licence: NJ DI08926) | |
| 122300000X Dentist (Licence: NJ DI07861) | |
| 122300000X Dentist (Licence: NJ DI14249) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ DI02215) | |
| 1223P0300X Dentist, Periodontics (Licence: NJ DI01216200) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |