| NPI | 1033424155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMENIC BAGLIVO President 610-642-0259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS-025340-L) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |