| Specialty Periodontal Care Of Washington Pa Llc | |
|
2790 West Chestnut Street Washington PA 15301 | |
| (724) 228-5800 | |
| (724) 223-5405 |
| Full Name | Specialty Periodontal Care Of Washington Pa Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2790 West Chestnut Street, Washington, Pennsylvania |
| Authorized Official Name and Position | Robert J Lacastro (OWNER) |
| Authorized Official Contact | 7242285800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialty Periodontal Care Of Washington Pa Llc 2790 West Chestnut Street Washington PA 15301 Ph: (724) 228-5800 | Specialty Periodontal Care Of Washington Pa Llc 2790 West Chestnut Street Washington PA 15301 Ph: (724) 228-5800 |
| NPI Number | 1689769788 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689769788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DS027670L (Pennsylvania) | Primary |
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