Organization
STATE COLLEGE ORTHODONTICS, P.C.
Active
Organization
STATE COLLEGE ORTHODONTICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE MARIE RAY D.M.D., M.S. (PRESIDENT)
(814) 308-9504
Entity
Organization
Contact information
Practice address
2565 PARK CENTER BLVD, SUITE 300, STATE COLLEGE, PA 16801-3007
(814) 308-9504
(814) 954-7723
Mailing address
2565 PARK CENTER BLVD, SUITE 300, STATE COLLEGE, PA 16801-3007
(814) 308-9504
(814) 954-7723
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS035437
PA
Other
Enumeration date
03/17/2011
Last updated
02/07/2012
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