| NPI | 1801338140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA DIBOS Co Owner 201-436-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2016-11-16 |