| NPI | 1124164256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SEBASTIAN DESALVO President 215-348-0909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS028368L) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-11-19 |