| NPI | 1730392630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN MALDONADO Owner 908-464-5630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ DI19327) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |