| NPI | 1073564522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MULL Director 570-271-6144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2019-02-28 |