| NPI | 1942471586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR POTEPALOV Dentist 732-972-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NJ 22DI02284000) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2008-04-01 |