| NPI | 1497327258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY ROMANO Practice Manager 814-942-4699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2021-07-12 |