| NPI | 1760838114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVIE M RICE Sole Member 908-502-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-07-19 |