NPI | 1033564315 |
---|---|
Entity Type | Organization |
Authorized Contact | DAWN PADGETT Credentialing Manager 215-955-1175 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
Additional Taxonomies | 122300000X Dentist |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
Enumeration Date | 2016-04-25 |
Last Update Date | 2024-06-13 |