| Charles G Shea Dmd Pc | |
|
225 Vine St Johnstown PA 15901 | |
| (814) 535-7888 | |
| (814) 539-8858 |
| Full Name | Charles G Shea Dmd Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 225 Vine St, Johnstown, Pennsylvania |
| Authorized Official Name and Position | Charles G Shea (OWNER) |
| Authorized Official Contact | 8145357888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles G Shea Dmd Pc 225 Vine St Johnstown PA 15901 Ph: (814) 535-7888 | Charles G Shea Dmd Pc 225 Vine St Johnstown PA 15901 Ph: (814) 535-7888 |
| NPI Number | 1912049115 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 09/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912049115 | NPI | - | NPPES |
| 0015391880001 | Medicaid | PA | |
| 160535 | Other | PA | BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS-018700-L (Pennsylvania) | Primary |
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