| NPI | 1528668076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLYN HODGES Owner 610-645-7640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2024-06-04 |