| NPI | 1215987078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT BRUCE PRUCHNIC President Of Corporation 814-467-4474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS019291L) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-08-22 |