| Russell T Wible Dmd | |
|
684 North Hermitage Rd Hermitage PA 16148 | |
| (724) 981-4222 | |
| (724) 981-4228 |
| Full Name | Russell T Wible Dmd |
|---|---|
| Speciality | Dentist |
| Location | 684 North Hermitage Rd, Hermitage, Pennsylvania |
| Authorized Official Name and Position | Russell Thomas Wible (PRESIDENT) |
| Authorized Official Contact | 7249814222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell T Wible Dmd 684 North Hermitage Rd Hermitage PA 16148 Ph: (724) 981-4222 | Russell T Wible Dmd 684 North Hermitage Rd Hermitage PA 16148 Ph: (724) 981-4222 |
| NPI Number | 1336101070 |
|---|---|
| Provider Enumeration Date | 04/06/2006 |
| Last Update Date | 10/25/2007 |
| Medicare PECOS PAC ID | 7012809445 |
|---|---|
| Medicare Enrollment ID | O20040329001169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336101070 | NPI | - | NPPES |
| 000000325486 | Other | OH | ONE NATION |
| 2375673 | Other | AETNA HMO | |
| 204563 | Other | PA | UPMC |
| 4420848 | Other | AETNA PPO | |
| 419683 | Other | PA | BC BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS027889L (Pennsylvania) | Primary |
| Provider Name | Russell T Wible |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1831376284 PECOS PAC ID: 8820008683 Enrollment ID: I20101201001184 |
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