NPI | 1023176260 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY M HOLLIS Owner 717-845-9664 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA ds030780l) |
Enumeration Date | 2006-12-04 |
Last Update Date | 2020-08-22 |