| NPI | 1417118480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS J. CIVILLICO Owner/Practitioner 610-352-6560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS019365L) |
| Enumeration Date | 2008-06-22 |
| Last Update Date | 2016-12-14 |