| NPI | 1841346830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN O FRASER President 732-826-8464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22D101529300) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22D101529300) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22D102188601) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22D102203608) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |