| NPI | 1376676379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN F STASIK President 215-639-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA ds014692l) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |