Lake Erie Dental, Inc. | |
4944 Peach St Erie PA 16509-2012 | |
(814) 864-7511 | |
(814) 866-1565 |
Full Name | Lake Erie Dental, Inc. |
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Speciality | Dentist - General Practice |
Location | 4944 Peach St, Erie, Pennsylvania |
Authorized Official Name and Position | Kevin Sambuchino (PRESIDENT) |
Authorized Official Contact | 8148647511 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lake Erie Dental, Inc. 4944 Peach St Erie PA 16509-2012 Ph: (814) 864-7511 | Lake Erie Dental, Inc. 4944 Peach St Erie PA 16509-2012 Ph: (814) 864-7511 |
NPI Number | 1275700577 |
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Provider Enumeration Date | 05/15/2008 |
Last Update Date | 05/15/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275700577 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 031305 (Pennsylvania) | Secondary |
1223G0001X | Dentist - General Practice | 17224 (Pennsylvania) | Primary |
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