| NPI | 1386396133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN COGAN Orthodontist 215-355-5995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2022-01-24 |