| NPI | 1831393685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA NILES Receptionist 570-253-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: PA ds020813L) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: PA ds035287) |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: PA BL5871187) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2007-07-25 |