| NPI | 1619955697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHINYELU N DIBOR Dental Director 215-843-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: PA DS029890L) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2020-08-22 |