| NPI | 1639370661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD VICTOR EIDELSON President Dentist 215-627-1995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS019673L) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2011-04-22 |