| NPI | 1023405552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P COOLICAN President 570-343-8166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS028134L) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |