| NPI | 1013133206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY EARL LANE Sole Member 724-836-4433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS0272161) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |