| NPI | 1124126891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LOUIS SANSONE Owner President 610-326-8785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS028302L) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DX020446R) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |