| NPI | 1053858613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MCINTYRE Owner 570-828-2312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401006019) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |