Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 22DI02843500 | NJ |
NPI | 1053989939 |
---|---|
Provider Name | Justin Pierotti |
First Address | Milmay, NJ 08340-3039 |
Second Address | Vineland, NJ 08360-8713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2021 |
Last Update Date | 16/06/2021 |