Back Mountain Dental, Inc. | |
210 Carverton Rd Trucksville PA 18708-1745 | |
(570) 696-1105 | |
(570) 696-4805 |
Full Name | Back Mountain Dental, Inc. |
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Speciality | Dentist - General Practice |
Location | 210 Carverton Rd, Trucksville, Pennsylvania |
Authorized Official Name and Position | James Clemens Definnis (PRESIDENT) |
Authorized Official Contact | 5706961105 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Back Mountain Dental, Inc. 210 Carverton Rd Trucksville PA 18708-1745 Ph: (570) 696-1105 | Back Mountain Dental, Inc. 210 Carverton Rd Trucksville PA 18708-1745 Ph: (570) 696-1105 |
NPI Number | 1245301381 |
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Provider Enumeration Date | 11/12/2006 |
Last Update Date | 11/04/2009 |
Identifier | Type | State | Issuer |
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1245301381 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | DS031113L (Pennsylvania) | Primary |