| NPI | 1710040878 |
|---|---|
| Doing Business As | GPHA WOODLAND AVE. DENTAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | D TINA SMITH Provider Enrollment Spec. 215-925-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2017-03-27 |