| NPI | 1164053054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN SHANK Quality Control Manager 610-372-6313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |