| NPI | 1861564502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED CHARLES BERGAMO President 201-261-0212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 220100796100) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |