| NPI | 1710008594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SHREVE JOHNESSEE Owner 717-747-0115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DSO17652L) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |