Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS025279L | PA |
NPI | 1023219441 |
---|---|
Provider Name | Dr. Joseph M Virgulti |
First Address | Exton, PA 19341 |
Second Address | Exton, PA 19341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 08/07/2007 |