| NPI | 1942664297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA IGDALEV Owner 201-224-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NJ 22DI02013400) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: NJ 22DI02604300) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |