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Organization
CENTERVILLE CLINICS INC
Active
Organization
CENTERVILLE CLINICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA MARTOS (DIRECTOR OF FINANCE/PERSONNEL)
(724) 632-6801
Entity
Organization
Contact information
Practice address
208 S ARCH ST, CONNELLSVILLE, PA 15425-3519
(724) 626-2630
(724) 626-2655
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
—
NULL
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
NULL
126800000X
Dental Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007288440037
—
PA
Enumeration date
11/18/2005
Last updated
04/17/2008
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