| NPI | 1013432590 |
|---|---|
| Doing Business As | BLOOMFIELD AVENUE DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | PHILIP SHIN Associate Dentist 610-284-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS029129L) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS029129L) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2022-07-21 |