# SELINSGROVE DENTAL & DENTURES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164913273
- **Authorized official:** DOUGLAS CLOSINSKI (VICE PRESIDENT/ MEMBER)
- **Authorized official phone:** (518) 376-6328

## Contact information

- **Practice address:** 2192 NORTH SUSQUEHANNA TRAIL, SUITE 200, SELINSGROVE, PA 17831
- **Practice address phone:** (570) 743-8000
- **Mailing address:** 111 HOMEPORT DR, PALM HARBOR, FL 34683-5410
- **Mailing address phone:** (716) 954-0141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/24/2018
- **Last updated:** 05/24/2018