| NPI | 1386692184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY F KEWITT Owner/President 814-235-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS029616L) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: PA MD073230L) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: PA MD073230L) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2024-04-18 |