NPI | 1639774128 |
---|---|
Entity Type | Organization |
Authorized Contact | PRANATHI REDDY Vice President 215-491-2139 |
Organization Subpart ? | No |
Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2020-12-02 |
Last Update Date | 2022-02-15 |