| NPI | 1700032562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA QUINTEROS Credentialing 724-901-1964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 043847) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2023-10-10 |