| NPI | 1326135930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON DOREEN CLARK Executive Director 570-988-0735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |