| NPI | 1275700577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN SAMBUCHINO President 814-864-7511 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA 17224) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA 031305) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |