NPI | 1518358951 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK EDWARD RONGONE Owner 570-759-9384 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS026776L) |
Enumeration Date | 2015-02-06 |
Last Update Date | 2015-02-06 |