| NPI | 1790152205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDI LEAS Front Office 717-632-8571 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS036611) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2016-01-13 |