| NPI | 1770755944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA MARTINEZ Office Manager 215-745-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA 020822) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2008-06-26 |