| NPI | 1356700835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI VISHIO Office Manager 215-677-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS022257L) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: PA DS039673) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-02-12 |