| NPI | 1912001298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KEITH TRACHTENBERG Dentist Partner 215-348-4172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS021017L) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS029525L) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2020-08-22 |