| NPI | 1487884516 |
|---|---|
| Doing Business As | FAMILY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ELENA M KOFMAN Owner/Dentist 610-692-1808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS29460L) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS035176) |
| 1223P0300X Dentist, Periodontics (Licence: PA DS036330) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2009-07-23 |