| NPI | 1104031756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE W. GROVE President 610-372-8406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS017881L) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |