| NPI | 1952447534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE E BOUDREAU Dmd President 215-387-0883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS035436) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS18680L) |
| 122300000X Dentist (Licence: PA DS19260L) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |