| NPI | 1578174843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA S GEORGE Dentist/Owner 724-934-3422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-08-11 |