| Pittston Dental Center | |
|
34 S Main St Pittston PA 18640-1827 | |
| (570) 654-2484 | |
| (570) 654-4867 |
| Full Name | Pittston Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 34 S Main St, Pittston, Pennsylvania |
| Authorized Official Name and Position | Timothy Mark Opiel (OWNER) |
| Authorized Official Contact | 5706542484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pittston Dental Center 34 S Main St Pittston PA 18640-1827 Ph: (570) 654-2484 | Pittston Dental Center 34 S Main St Pittston PA 18640-1827 Ph: (570) 654-2484 |
| NPI Number | 1720479637 |
|---|---|
| Provider Enumeration Date | 02/13/2015 |
| Last Update Date | 02/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720479637 | NPI | - | NPPES |
| 1025160190002 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS038284 (Pennsylvania) | Primary |
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