| NPI | 1013005628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MICHAEL KELLY President 610-429-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS-019426L) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |