| NPI | 1528197498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN FONTANA Office Manager 610-821-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS014226L) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS027267L) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |