| Cosmetic Dentistry Inc | |
|
110 Radnor Rd Suite 200 State College PA 16801-7987 | |
| (814) 238-2020 | |
| Not Available |
| Full Name | Cosmetic Dentistry Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 110 Radnor Rd, State College, Pennsylvania |
| Authorized Official Name and Position | Robert Leon Jeanmenne (OWNER, PRESIDENT) |
| Authorized Official Contact | 8142382020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cosmetic Dentistry Inc 110 Radnor Rd Suite 200 State College PA 16801-7987 Ph: (814) 238-2020 | Cosmetic Dentistry Inc 110 Radnor Rd Suite 200 State College PA 16801-7987 Ph: (814) 238-2020 |
| NPI Number | 1043626450 |
|---|---|
| Provider Enumeration Date | 07/07/2014 |
| Last Update Date | 07/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043626450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS035349 (Pennsylvania) | Primary |
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