Stephen Joseph Ollock, DMD | |
116 Seymour St, Blossburg, PA 16912-1418 | |
(570) 638-3468 | |
(570) 638-3637 |
Full Name | Stephen Joseph Ollock |
---|---|
Gender | Male |
Speciality | Dentist |
Location | 116 Seymour St, Blossburg, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003136904 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DS038254 (Pennsylvania) | Primary |
Entity Name | North Penn Comprehensive Health Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912093576 PECOS PAC ID: 0446245880 Enrollment ID: O20040416000152 |
Mailing Address | Practice Location Address |
---|---|
Stephen Joseph Ollock, DMD 40 W Wellsboro St, Mansfield, PA 16933-1411 Ph: (570) 662-1945 | Stephen Joseph Ollock, DMD 116 Seymour St, Blossburg, PA 16912-1418 Ph: (570) 638-3468 |
Melody A Dematteis, Dentist Medicare: Not Enrolled in Medicare Practice Location: 116 Seymour St, Blossburg, PA 16912 Phone: 570-638-2174 | |
Dr. Kathleen Carew Lamontagne, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 116 Seymour St, Blossburg, PA 16912 Phone: 570-638-3468 | |
Mrs. Kathryn Kelsey Herrmann, RDH Dentist Medicare: Not Enrolled in Medicare Practice Location: 116 Seymour St, Blossburg, PA 16912 Phone: 570-638-3468 Fax: 570-638-3637 |