| NPI | 1184849028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARROLL E DITZLER Owner 717-273-7627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS015614L) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |