| NPI | 1326574286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT FORNALCZYK Owner 724-282-4436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA ds021397L) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |