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Oral and Maxillofacial Surgery

Erie, Pennsylvania

Provider NPI: 1417258724

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
5158 PEACH ST  ERIE, PA 16509 US
Tel: 814-868-3647  Fax: 814-864-2715

Business Mailing Address:
1021 W 6TH ST  ERIE, PA 16507 US
Tel: 941-232-2086  Fax: 941-343-3849

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y1223S0112XDental Providers
Oral and Maxillofacial Surgery
Oral & Maxillofacial Surgery


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