| Minichelli Dentistry, Inc. | |
|
2606 Caughey Rd Erie PA 16506-2148 | |
| (814) 833-4393 | |
| (814) 838-0781 |
| Full Name | Minichelli Dentistry, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2606 Caughey Rd, Erie, Pennsylvania |
| Authorized Official Name and Position | Mark Richard Minichelli (PRESIDENT) |
| Authorized Official Contact | 8148334393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minichelli Dentistry, Inc. 2606 Caughey Rd Erie PA 16506-2148 Ph: (814) 833-4393 | Minichelli Dentistry, Inc. 2606 Caughey Rd Erie PA 16506-2148 Ph: (814) 833-4393 |
| NPI Number | 1275677452 |
|---|---|
| Provider Enumeration Date | 02/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275677452 | NPI | - | NPPES |
| 608515 | Other | PA | UCCI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS027249L (Pennsylvania) | Primary |
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