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Organization
WESTERN PENNSYLVANIA DENTAL GROUP
Active
Organization
WESTERN PENNSYLVANIA DENTAL GROUP
Active
Parent organization
WESTERN PENNSYLVANIA DENTAL GROUP
Other names
Chestnut Hills Dental Johnstown Upper Yoder
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN PENNSYLVANIA DENTAL GROUP
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
322 WARREN ST STE 150, JOHNSTOWN, PA 15905-3443
(814) 619-2410
Mailing address
322 WARREN ST STE 150, JOHNSTOWN, PA 15905-3443
(814) 619-2410
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
DS029676L
PA
Other
Enumeration date
11/21/2012
Last updated
04/18/2022
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