| NPI | 1508677493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB PAULY GRIBB Owner/Surgeon 610-310-5696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-01-18 |
| Last Update Date | 2025-01-18 |