| NPI | 1912298589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEISTER HOWARD LINN Owner 570-326-6181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS018760L) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2011-04-29 |