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Organization
AFFORDABLE SMILES OF CORRY
Active
Organization
AFFORDABLE SMILES OF CORRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEVI R EVALT DDS (OWNER)
(814) 664-2012
Entity
Organization
Contact information
Practice address
209 N CENTER ST, CORRY, PA 16407-1626
(814) 664-2012
(814) 664-2017
Mailing address
209 N CENTER ST, CORRY, PA 16407-1626
(814) 664-2012
(814) 664-2017
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS035205
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19678900
—
PA
Enumeration date
04/30/2018
Last updated
04/30/2018
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