| NPI | 1982743944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY E ETTELSON President Dentist 856-227-2554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 08424) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA D5015997L) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |