| NPI | 1962522813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MORRIS THALER General Partner 814-942-7216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS030236L) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS029854L) |
| Enumeration Date | 2007-04-01 |
| Last Update Date | 2020-08-22 |