| NPI | 1073641148 |
|---|---|
| Doing Business As | SOUTHEASTERN PA ORAL SURGERY LLC |
| Entity Type | Organization |
| Authorized Contact | BRIAN M SMITH Chairman 215-707-7138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-13 |