| NPI | 1639199433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY LEE HOLDEN President 814-231-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS024069L) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: PA DS024069L) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-01-16 |