NPI | 1326493321 |
---|---|
Doing Business As | GPHA INC. MEDICAL SUITE AT TEMPLE'S DENTAL SCHOOL |
Entity Type | Organization |
Authorized Contact | D TINA SMITH Provider Enrollment Spec. 215-925-2400 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2016-04-27 |
Last Update Date | 2017-03-15 |