| NPI | 1477143568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENG CHENG Owner/Dentist 814-942-4699 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2021-01-22 |