| NPI | 1487710190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRIS L LEWIS MOODY Dentist 215-848-6446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS024507L) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS23581L) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2014-01-14 |