| NPI | 1073853263 |
|---|---|
| Doing Business As | LONG CREEK FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | PATRICE LISSADE Co Owner 610-202-3230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2013-04-22 |