| Prime Dental | |
|
272 Cross Roads Plz Mount Pleasant PA 15666-2288 | |
| (724) 547-0690 | |
| Not Available |
| Full Name | Prime Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 272 Cross Roads Plz, Mount Pleasant, Pennsylvania |
| Authorized Official Name and Position | Tatiana O Lucas (DENTIST OWNER) |
| Authorized Official Contact | 7245470690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Dental 272 Crossroads Plz Unit 4 Mount Pleasant PA 15666-2288 Ph: (724) 547-0690 | Prime Dental 272 Cross Roads Plz Mount Pleasant PA 15666-2288 Ph: (724) 547-0690 |
| NPI Number | 1467976878 |
|---|---|
| Provider Enumeration Date | 07/27/2017 |
| Last Update Date | 06/17/2020 |
| Medicare PECOS PAC ID | 5890058580 |
|---|---|
| Medicare Enrollment ID | O20180411000246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467976878 | NPI | - | NPPES |
| 1033533390001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Tatiana O Lucas |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1114473576 PECOS PAC ID: 9335402023 Enrollment ID: I20180411000292 |
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