| NPI | 1689269441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIPA THAKKAR Member 610-436-4512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 122300000X Dentist | |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2021-04-08 |