| NPI | 1588430060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HOGAN COO 717-636-1907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-12-22 |