| NPI | 1770592594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA B WOLGIN Co President 215-735-1131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS15962L) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS030806L) |
| 122300000X Dentist (Licence: PA DS028500L) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |