| NPI | 1134510001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS R WEBER Member 814-868-5411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS020914L) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2015-02-12 |