| NPI | 1336673417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WAXMAN Office Manager 610-667-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS040852) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |