| NPI | 1306170055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT A HAZZOURI Owner 570-342-9136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS024299L) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS023426) |
| 122300000X Dentist (Licence: PA DS036530) | |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |