NPI | 1699966457 |
---|---|
Entity Type | Organization |
Authorized Contact | JACK LEE MALVIN President 412-661-7316 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA 020641) |
Enumeration Date | 2007-08-07 |
Last Update Date | 2007-08-07 |