| NPI | 1154787745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE SHOENBERGER Member 610-248-9683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS037358) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS037255) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-29 |