# MCKEES ROCKS DENTAL

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

## Provider details

- **NPI number:** 1184155327
- **Authorized official:** JASON FEDERER (OWNER)
- **Authorized official phone:** (727) 463-8284

## Contact information

- **Practice address:** 757 CHARTIERS AVE, MC KEES ROCKS, PA 15136-3622
- **Practice address phone:** (412) 331-4629
- **Mailing address:** PO BOX 66, HOUSTON, PA 15342-0066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 03/21/2017
- **Last updated:** 03/21/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 103099940-0001 | — | PA |