| NPI | 1558381897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS EUGENE LONG Executive Director 717-394-3793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PA DS013902L) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS018611) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS035366) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |