| NPI | 1427587047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A MILLIRON Executive Administrator 724-978-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS021586L) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: PA DS017612L) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2017-06-07 |