| NPI | 1942306774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL EDWARD BACCELLIERI Partner 610-444-0208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS018102L) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS030182L) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-08-22 |