| NPI | 1740554534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN QUISPE Office Manager 973-817-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2012-02-27 |