| NPI | 1396223715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE BURKETT Office Manager 814-623-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |