| NPI | 1861645145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHRAM SHAMLOO Vice President 610-363-5810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS036955) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037327) |
| 122300000X Dentist (Licence: PA DS037059) | |
| 122300000X Dentist (Licence: PA DS036832) | |
| 1223E0200X Dentist, Endodontics (Licence: PA DS037059) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS023283Y) | |
| 1223P0300X Dentist, Periodontics (Licence: PA DS036138) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS036830) | |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2010-03-09 |