| NPI | 1376945550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA H MONROE Associate 610-566-0291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS039904) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: NY 50 057464) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2014-09-19 |