| NPI | 1912111782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY L BUPP President 724-837-3318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS020754L) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |