# NORTHEAST DENTAL SURGERY CENTER PC

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

## Provider details

- **NPI number:** 1639614837
- **Authorized official:** MR. SHAWN M CASEY DMD (GENERAL DENTIST)
- **Authorized official phone:** (570) 237-1838

## Contact information

- **Practice address:** 1073 OAK ST, B STE, PITTSTON, PA 18640-3716
- **Practice address phone:** (570) 237-1838
- **Mailing address:** 1073 OAK ST, B STE, PITTSTON, PA 18640-3716
- **Mailing address phone:** (570) 237-1838

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 12/23/2016
- **Last updated:** 12/23/2016