| NPI | 1437509841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHONG TA Dentist Anesthesiologist/Owner 215-527-8768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NY 054360) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |