| NPI | 1851550826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN FOX Insurance Manager 215-214-5994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS031283L) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2015-12-18 |