| NPI | 1902373111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MCKAMEY Credentialing Specialist 215-467-3190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2018-10-26 |