| Loyalsock Dental Associates | |
|
1501 Washington Blvd Williamsport PA 17701-5426 | |
| (570) 323-6116 | |
| (570) 323-5850 |
| Full Name | Loyalsock Dental Associates |
|---|---|
| Speciality | Dentist |
| Location | 1501 Washington Blvd, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Ralph Van Shaffer (PRESIDENT) |
| Authorized Official Contact | 5703236116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loyalsock Dental Associates 1501 Washington Blvd Williamsport PA 17701-5426 Ph: (570) 323-6116 | Loyalsock Dental Associates 1501 Washington Blvd Williamsport PA 17701-5426 Ph: (570) 323-6116 |
| NPI Number | 1801913009 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801913009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS020882L (Pennsylvania) | Primary |
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