# MICHAEL V. JACONSKI, DMD,PC

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

## Provider details

- **NPI number:** 1619052040
- **Authorized official:** DR. MICHAEL V. JACONSKI DMD (OWNER)
- **Authorized official phone:** (412) 486-6777

## Contact information

- **Practice address:** 4000 MOUNT ROYAL BLVD, ALLISON PARK, PA 15101-2918
- **Practice address phone:** (412) 486-6777
- **Practice address fax:** (412) 487-8161
- **Mailing address:** 4000 MOUNT ROYAL BLVD, ALLISON PARK, PA 15101-2918
- **Mailing address phone:** (412) 486-6777
- **Mailing address fax:** (412) 487-8161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS025964L | PA | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1587105 | UNITED CONCORDIA | PA |