| NPI | 1881712198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA GAIL O'DONNELL Orthodontist Officer Of Pa 512-260-0084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 18829) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |