| NPI | 1902954001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENEDICT ANTONECCHIA Director 973-478-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 11905) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 10967) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |