| NPI | 1780102749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE DEBRA BAALS Director Of Operations 856-381-7196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS0190987L) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2017-08-30 |