| NPI | 1295031680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMELA BROOKE PHAM Office Manager 814-366-2008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS036673) |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2011-02-01 |