| NPI | 1013010982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY CHABALLA-WILDE Partner 717-581-9394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS027636L) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS026723L) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2013-06-13 |