| NPI | 1235451469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT JOSEPH BONOMO Owner/Dentist 215-238-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS025793l) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2010-02-15 |