| NPI | 1184214934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATILDA DHIMA Manager 215-459-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2021-01-25 |