| NPI | 1760741730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH JOHNSON Practice Manager 484-278-4134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: PA DS024203L) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2012-05-11 |