| NPI | 1487172359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILOU DIBAGNO Office Manager 724-542-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS030164L) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DS035406) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2022-07-21 |