| NPI | 1619079704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD G JACOBSON Owner 610-265-4142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA 06-0000001653) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-08-22 |