| NPI | 1952713554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA HORTON LEWIS Executive Director 610-383-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DH005232L) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: PA PHDH000185) |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2014-05-30 |