| NPI | 1659509404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MEDIANICK Owner 610-775-0321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA Ds036510) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DN017638) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2009-07-27 |