| NPI | 1821721622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JIN Owner/Mbr Mgr 201-224-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| 261QM2500X Clinic/Center Medical Specialty | |
| 261QS0112X Clinic/Center Oral and Maxillofacial Surgery | |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2022-10-21 |