| NPI | 1134584899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE T FAN Owner 215-629-0596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS-030933-L) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2015-12-23 |