| NPI | 1760992432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELBA PATRICIA BONELLI CEO 609-923-5730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ DI19272) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ DI19272) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2017-10-06 |