| Valley Oral Surgeon, Ltd. | |
|
20 Osborne St Johnstown PA 15905-4128 | |
| (814) 536-4675 | |
| (814) 536-8897 |
| Full Name | Valley Oral Surgeon, Ltd. |
|---|---|
| Speciality | Dentist |
| Location | 20 Osborne St, Johnstown, Pennsylvania |
| Authorized Official Name and Position | Michael L.. Delrosario (OWNER) |
| Authorized Official Contact | 8145364675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Oral Surgeon, Ltd. 20 Osborne St Johnstown PA 15905-4128 Ph: (814) 536-4675 | Valley Oral Surgeon, Ltd. 20 Osborne St Johnstown PA 15905-4128 Ph: (814) 536-4675 |
| NPI Number | 1922043322 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3577501741 |
|---|---|
| Medicare Enrollment ID | O20050419000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922043322 | NPI | - | NPPES |
| 102928 | Other | PA | UPMC PIN |
| VA112926 | Other | PA | HIGHMARK GROUP PRACTICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS028079L (Pennsylvania) | Primary |
| Provider Name | Michael L Delrosario |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1588739353 PECOS PAC ID: 0042498024 Enrollment ID: I20110621000698 |
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