| NPI | 1356782700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE M. SHEA Practice Manager 814-535-7888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2013-07-15 |