| NPI | 1811371008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE WINKLER Revenue Cycle Manager 717-590-1513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |