| NPI | 1922486422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD WAN Dentist 908-782-6606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NJ 22di02454100) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2015-05-15 |