| NPI | 1942285408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M. WILCKO Officer/Dentist 814-868-3654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: PA 019714) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-08-22 |