# COOPERSBURG DENTAL PLLC

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

## Provider details

- **NPI number:** 1508453036
- **Authorized official:** ELIZABETH GALVIN (BILLING MANAGER)
- **Authorized official phone:** (570) 655-7645

## Contact information

- **Practice address:** 20 S MAIN ST, COOPERSBURG, PA 18036-1911
- **Practice address phone:** (610) 282-1700
- **Mailing address:** 457 N MAIN ST STE 100, PITTSTON, PA 18640-2185
- **Mailing address phone:** (570) 655-7645
- **Mailing address fax:** (570) 299-7427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/30/2020
- **Last updated:** 12/30/2020