| Davidson- Tucker Oral Surgery Associates | |
|
17 Arentzen Blvd Suite #104 Charleroi PA 15022-1085 | |
| (724) 483-5080 | |
| (724) 483-3760 |
| Full Name | Davidson- Tucker Oral Surgery Associates |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 17 Arentzen Blvd, Charleroi, Pennsylvania |
| Authorized Official Name and Position | Charles Peter Tucker (PRESIDENT, DAVIDSON-TUCKER ORAL SUR) |
| Authorized Official Contact | 7244835080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Davidson- Tucker Oral Surgery Associates 17 Arentzen Blvd Suite #104 Charleroi PA 15022-1085 Ph: (724) 483-5080 | Davidson- Tucker Oral Surgery Associates 17 Arentzen Blvd Suite #104 Charleroi PA 15022-1085 Ph: (724) 483-5080 |
| NPI Number | 1629007505 |
|---|---|
| Provider Enumeration Date | 07/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629007505 | NPI | - | NPPES |
| 0525357 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS026650-L (Pennsylvania) | Primary |
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