| NPI | 1700593779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA QUINTEROS Credentialing 724-698-2135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2023-12-14 |