| NPI | 1407371958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE VARGAS Owner 717-601-9419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 8819) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 8818) |
| Enumeration Date | 2017-08-06 |
| Last Update Date | 2022-07-21 |