| Pottsville Oral Surgery, Pc | |
|
2257 W End Ave Pottsville PA 17901-1825 | |
| (570) 622-9746 | |
| (570) 622-3723 |
| Full Name | Pottsville Oral Surgery, Pc |
|---|---|
| Speciality | Dentist |
| Location | 2257 W End Ave, Pottsville, Pennsylvania |
| Authorized Official Name and Position | Jeffrey Horowitz (PRESIDENT) |
| Authorized Official Contact | 5706229746 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pottsville Oral Surgery, Pc 2257 W End Ave Pottsville PA 17901-1825 Ph: (570) 622-9746 | Pottsville Oral Surgery, Pc 2257 W End Ave Pottsville PA 17901-1825 Ph: (570) 622-9746 |
| NPI Number | 1518975671 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 06/30/2017 |
| Medicare PECOS PAC ID | 6901809839 |
|---|---|
| Medicare Enrollment ID | O20060816000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518975671 | NPI | - | NPPES |
| 11013134 | Other | PA | CAQH # |
| 1649251570 | Other | PA | NPI INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS031220-L (Pennsylvania) | Primary |
| Provider Name | Jeffrey A Horowtiz |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1649251570 PECOS PAC ID: 8325051766 Enrollment ID: I20060801000207 |
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