| Susquehanna Oral & Facial Surgery & Implant Center | |
|
1701 Four Mile Dr Williamsport PA 17701-1940 | |
| (570) 323-1900 | |
| (570) 323-6079 |
| Full Name | Susquehanna Oral & Facial Surgery & Implant Center |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1701 Four Mile Dr, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Marc S Rosenthal (OWNER) |
| Authorized Official Contact | 5703231900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susquehanna Oral & Facial Surgery & Implant Center 1701 Four Mile Dr Williamsport PA 17701-1940 Ph: (570) 323-1900 | Susquehanna Oral & Facial Surgery & Implant Center 1701 Four Mile Dr Williamsport PA 17701-1940 Ph: (570) 323-1900 |
| NPI Number | 1275905929 |
|---|---|
| Provider Enumeration Date | 10/21/2015 |
| Last Update Date | 10/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275905929 | NPI | - | NPPES |
| 1699852137 | Other | PA | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS029213L (Pennsylvania) | Primary |
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