| NPI | 1962834846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA SUAREZ Manager 201-803-4988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 5957) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2013-08-02 |