# NITTANY DENTAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Nittany Dental Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356462337
- **Authorized official:** DR. ROBERT LEON JEANMENNE DDS (PRESIDENT)
- **Authorized official phone:** (814) 238-0088

## Contact information

- **Practice address:** 2601 GATEWAY DR, SUITE 250, STATE COLLEGE, PA 16801-3213
- **Practice address phone:** (814) 238-0088
- **Mailing address:** 2601 GATEWAY DR, SUITE 250, STATE COLLEGE, PA 16801-3213
- **Mailing address phone:** (814) 238-0088

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS035349 | PA | Yes |
| 1223G0001X | General Practice Dentistry | DS035452 | PA | — |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 08/22/2020