| NPI | 1750650172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SWAMISARAN PATEL Manager 215-848-8214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2017-02-16 |