| NPI | 1346322799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH KACZOR President 814-944-6355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS022361-L) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2009-06-18 |