| NPI | 1003044264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT I DISALVO President 570-322-4741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA ds015354l) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2009-06-26 |