| 4 Kids Dental Center, P.c. | |
|
660 E Pittsburgh St Greensburg PA 15601-2677 | |
| (724) 837-4400 | |
| (724) 837-1613 |
| Full Name | 4 Kids Dental Center, P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 660 E Pittsburgh St, Greensburg, Pennsylvania |
| Authorized Official Name and Position | Christopher James Luccy (PRESIDENT) |
| Authorized Official Contact | 7248374400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 4 Kids Dental Center, P.c. 660 E Pittsburgh St Greensburg PA 15601-2677 Ph: (724) 837-4400 | 4 Kids Dental Center, P.c. 660 E Pittsburgh St Greensburg PA 15601-2677 Ph: (724) 837-4400 |
| NPI Number | 1962673632 |
|---|---|
| Provider Enumeration Date | 03/20/2008 |
| Last Update Date | 01/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962673632 | NPI | - | NPPES |
| 0007813660002 | Medicaid | PA | |
| 0017262150001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS 015320 L (Pennsylvania) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | DS 018180 L (Pennsylvania) | Primary |
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