| NPI | 1154740579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRINA STEPANSKY Dentist 215-673-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: PA DS029548L) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2014-04-14 |