| NPI | 1790290146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY HERNANDEZ Team Lead 609-646-1989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DI22906) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2017-12-07 |