| NPI | 1942380407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE MARCELLUS TAYLOR Vice President 215-474-8415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA PA023171L) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |