| NPI | 1932323235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CARMEN SQUILLARO President 215-463-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS017459L) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2013-05-14 |