| NPI | 1487043055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY MCDOWELL Office Manager 215-885-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS038674) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS019738) |
| 122300000X Dentist (Licence: PA DS040130) | |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |