| NPI | 1417293739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD GRATZ Manager 484-231-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: PA DS035811L) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: PA DS027440L) |
| 1223P0300X Dentist Periodontics (Licence: PA DS024390L) | |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2012-12-17 |