| NPI | 1730406109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGIL JASON VIVES Orthodontist 732-727-6666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DIO46000) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2010-04-26 |