| NPI | 1831591858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LEE Owner 215-550-7186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS038507) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2014-09-22 |