| NPI | 1205138088 |
|---|---|
| Other Name | UNIVERSITY SQUARE DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | SHARI TARA LEAVITT Dentist/President 215-662-1030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS-025799-L) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2010-11-29 |