| NPI | 1629284914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANEL M PUSKAR Office Account Manager 570-823-2162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS019434) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS029019L) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |