| NPI | 1932637618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN MAHER Licensing COO Rdinator 973-598-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02671900) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2017-05-25 |