| NPI | 1275133811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVESH P PATEL Owner 215-900-0576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |