| NPI | 1871666586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERAWATI T KANDOU President Orthodontist 908-354-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 9708) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 3026) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2008-05-30 |