| NPI | 1790029031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FRATTELLONE Owner 732-842-5915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 16514) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |