| NPI | 1912483538 |
|---|---|
| Doing Business As | IDEAL SMILE |
| Entity Type | Organization |
| Authorized Contact | ELIZABETGH MQ LO PICCOLO Practice Manager 215-859-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |