| NPI | 1063536290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH GIAN-GRASSO Owner 215-732-4450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS018466L) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |