Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 10202 | NJ |
NPI | 1104809599 |
---|---|
Provider Name | Dr. Donn Harris Winokur |
First Address | Toms River, NJ 08755-8050 |
Second Address | Toms River, NJ 08755-8050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 08/07/2007 |