| NPI | 1386625366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRE BALACI Owner President 610-373-7823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2010-10-12 |