| NPI | 1184060501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINNENE MATZULIS Office Manager 215-887-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS029793L) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-05-13 |