| Mill Creek Dental, Llc | |
|
497 N Claude A Lord Blvd Pottsville PA 17901-2705 | |
| (570) 516-9109 | |
| (570) 516-9138 |
| Full Name | Mill Creek Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 497 N Claude A Lord Blvd, Pottsville, Pennsylvania |
| Authorized Official Name and Position | David Pelagio (DENTIST) |
| Authorized Official Contact | 5705169109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mill Creek Dental, Llc 497 N Claude A Lord Blvd Pottsville PA 17901-2705 Ph: (570) 516-9109 | Mill Creek Dental, Llc 497 N Claude A Lord Blvd Pottsville PA 17901-2705 Ph: (570) 516-9109 |
| NPI Number | 1134560394 |
|---|---|
| Provider Enumeration Date | 07/16/2013 |
| Last Update Date | 07/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134560394 | NPI | - | NPPES |
| 0018499770003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS031640L (Pennsylvania) | Primary |
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