# SULLIVAN COUNTY ACTION,INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sullivan County Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063704500
- **Authorized official:** MR. JAMES C ROGERS (PRESIDENT)
- **Authorized official phone:** (570) 946-4107

## Contact information

- **Practice address:** 217 KING STREET, LAPORTE, PA 18626
- **Practice address phone:** (570) 946-5101
- **Practice address fax:** (570) 946-4341
- **Mailing address:** PO BOX 1, LAPORTE, PA 18626-0001
- **Mailing address phone:** (570) 946-4107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 124Q00000X | Dental Hygienist | — | NULL | — |
| 124Q00000X | Dental Hygienist | — | — | — |

## Other

- **Enumeration date:** 05/03/2011
- **Last updated:** 05/03/2011