| NPI | 1376658369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN WILLIAM PASKOW President 610-444-4033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS020583L) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS020698L) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |