| NPI | 1255507141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN FOX Insurance Manager 215-743-3700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS0020222L) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2013-08-12 |