| NPI | 1225437890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD M MARKS Dentist 814-234-0329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS018302) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2015-01-05 |