Moosic Dental Group Inc | |
502 Church Street Moosic PA 18507 | |
(570) 344-3500 | |
(570) 344-9442 |
Full Name | Moosic Dental Group Inc |
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Speciality | Dentist |
Location | 502 Church Street, Moosic, Pennsylvania |
Authorized Official Name and Position | Nolen Scott Ely (OWNER) |
Authorized Official Contact | 5703443500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Moosic Dental Group Inc 502 Church Street Moosic PA 18507 Ph: (570) 344-3500 | Moosic Dental Group Inc 502 Church Street Moosic PA 18507 Ph: (570) 344-3500 |
NPI Number | 1316044431 |
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Provider Enumeration Date | 09/20/2006 |
Last Update Date | 06/25/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316044431 | NPI | - | NPPES |
1014984530002 | Medicaid | PA | |
162464 | Other | PA | UNISON |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DS030419L (Pennsylvania) | Primary |