Healthcare Provider Details

I. General information

NPI: 1730362880
Provider Name (Legal Business Name): LEHRIAN AND PALO ORAL SURGERY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STATE ST SUITE B102
ERIE PA
16507-1452
US

IV. Provider business mailing address

100 STATE ST SUITE B102
ERIE PA
16507-1452
US

V. Phone/Fax

Practice location:
  • Phone: 814-454-3871
  • Fax: 814-454-6294
Mailing address:
  • Phone: 814-454-3871
  • Fax: 814-454-6294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID EDWARD PALO
Title or Position: PRESIDENT
Credential: DDS
Phone: 814-454-3871