| NPI | 1750783585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK R VAN ISTENDAL Owner 856-983-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NJ 22DI00903200) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |