| NPI | 1811078785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERALD N. ROSENBERG Owner 201-794-0260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI01598300) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2016-08-23 |