| NPI | 1902265036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRAIG ADAM FISCHGRUND Owner 201-572-9028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 056265) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |