| NPI | 1487665741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY G. WADSWORTH Owner 570-342-9246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: PA DS025280L) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2012-04-03 |