| NPI | 1619225810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY M GORDON President/Dental Director 717-632-1332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA 24985) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2018-06-29 |