| NPI | 1053629220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW CHERIAN President 215-663-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS 035070) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA ds 035070) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2010-09-21 |