| NPI | 1629007505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PETER TUCKER President, Davidson Tucker Oral Sur 724-483-5080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: PA DS026650-L) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-08-22 |