# JCR CENTURY DENTAL DAL LLC

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

## Provider details

- **NPI number:** 1598571853
- **Authorized official:** JASON HANYON DMD (OWNER)
- **Authorized official phone:** (570) 876-4488

## Contact information

- **Practice address:** 15 LINCOLN ST, DALLAS, PA 18612-1213
- **Practice address phone:** (570) 675-3646
- **Practice address fax:** (570) 674-3994
- **Mailing address:** 15 LINCOLN ST, DALLAS, PA 18612-1213
- **Mailing address phone:** (570) 675-3646
- **Mailing address fax:** (570) 674-3994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/10/2024
- **Last updated:** 12/10/2024