# PA-FM DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ASPEN DENTAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598190621
- **Legal business name:** ASPEN DENTAL
- **Authorized official:** JASON BERTOLLINI (PRM)
- **Authorized official phone:** (866) 273-8204

## Contact information

- **Practice address:** 508 BRIGHTON CT, GREENSBURG, PA 15601-9693
- **Practice address phone:** (866) 273-8204
- **Practice address fax:** (866) 803-4943
- **Mailing address:** PO BOX 3189, SYRACUSE, NY 13220-3189
- **Mailing address phone:** (866) 273-8204
- **Mailing address fax:** (866) 803-4943

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 29654 | PA | Yes |

## Other

- **Enumeration date:** 09/09/2013
- **Last updated:** 09/09/2013