| NPI | 1578740726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY L BORST Office Manager 610-437-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS-020111-L) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS-019309-L) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2008-01-29 |