| NPI | 1518263193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY L KLOO Financial Coordinator 610-865-5082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS022547L) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038243) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2011-01-31 |