| NPI | 1760899553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L POTTER Periodontist 610-433-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 292200000X Dental Laboratory (Licence: PA DSL028897L) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2014-07-14 |