Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 22DIO2439200 | NJ |
NPI | 1023290566 |
---|---|
Provider Name | Dr. Petar Hinic |
First Address | Summit, NJ 07901-2856 |
Second Address | Summit, NJ 07901-2856 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2007 |
Last Update Date | 11/07/2011 |