| NPI | 1427426188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUBODH P NAIR Manager 215-390-6847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN19874) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: FL DN19875) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |