| NPI | 1679799936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY W UPDEGROVE Owner 717-848-2947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS015730L) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS030039L) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |