| 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 |