| NPI | 1992255442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT NAKAMURA Managing Member 610-363-5887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA ds029571l) |
| Enumeration Date | 2016-10-08 |
| Last Update Date | 2016-10-08 |