| NPI | 1023388196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYANT JONES Owner 215-904-8951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: PA DS038152) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2016-01-19 |