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 |