| NPI | 1720290067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REZA ASSAD Dentist 610-640-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS-029820-L) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: PA DS-029820-L) |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2020-08-22 |