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Organization
CENTURY ORAL SURGERY PC
Active
Organization
CENTURY ORAL SURGERY PC
Active
Other names
Russell T Wible DMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL THOMAS WIBLE DMD (PRESIDENT)
(724) 981-4222
Entity
Organization
Contact information
Practice address
684 NORTH HERMITAGE RD, HERMITAGE, PA 16148
(724) 981-4222
(724) 981-4228
Mailing address
684 NORTH HERMITAGE RD, HERMITAGE, PA 16148
(724) 981-4222
(724) 981-4228
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS027889L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000325486
ONE NATION
OH
01
—
204563
UPMC
PA
01
—
2375673
AETNA HMO
—
01
—
419683
BC BS
PA
01
—
4420848
AETNA PPO
—
Enumeration date
04/06/2006
Last updated
10/25/2007
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