| NPI | 1427441906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY BOGHARA Manager 215-699-9058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |