| NPI | 1770769747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON S ELIMANCO Owner 732-780-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DIO18425) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2008-01-21 |