| NPI | 1972712529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE N CONSTANDELIS Owner 973-684-1078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 11019) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |