| NPI | 1215030283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN H DAMCOTT Associate Former Partner 814-868-5411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS019797L) |
| 1223P0300X Dentist, Periodontics (Licence: PA DS016060L) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |