Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 22DI01476600 | NJ |
NPI | 1013021948 |
---|---|
Provider Name | Dr. Keith Lawrence Dunoff |
First Address | West Berlin, NJ 08091-1424 |
Second Address | West Berlin, NJ 08091-1424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |