| NPI | 1023470895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | I. JAY FREEDMAN Owner 215-695-6666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS020755L) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: PA DS026216L) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |