| NPI | 1750158069 |
|---|---|
| Former Legal Business Name | GARDEN STATE GRINS |
| Entity Type | Organization |
| Authorized Contact | THOMAS ROLLO Dentist 862-596-2898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2023-12-06 |