| NPI | 1285047431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE GRANT Office Manager 724-759-7948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DS036141) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DS035406) |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DS031543L) | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DS029696L) | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DP000682) | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DA031643) | |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |