| NPI | 1831642917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE COADY Office Manager 215-567-2666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: PA DS017950) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-07-26 |