| NPI | 1437309556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN MALIA Office Manager 570-655-3040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS027282L) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS034240) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2008-09-25 |