| NPI | 1477567782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WAXMAN Office Manager 484-680-6405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS023126L) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2022-03-04 |