| NPI | 1629166020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT J BONOMO Owner/Vice President 215-238-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA ds025793-l) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |