| NPI | 1760917918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA SANDERS Non Member Manager 201-304-4137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 040944) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |