# CCA DENTAL GROUP LLC

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

## Provider details

- **NPI number:** 1609718006
- **Authorized official:** DR. CORTNEY ARCHBOLD DDS (MANAGER)
- **Authorized official phone:** (814) 868-3647

## Contact information

- **Practice address:** 5158 PEACH ST \# 110, ERIE, PA 16509-2489
- **Practice address phone:** (814) 868-3647
- **Practice address fax:** (814) 864-2715
- **Mailing address:** 5158 PEACH ST \# 110, ERIE, PA 16509-2489
- **Mailing address phone:** (814) 868-3647
- **Mailing address fax:** (814) 864-2715

## Taxonomy

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

## Other

- **Enumeration date:** 04/07/2026
- **Last updated:** 04/07/2026