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Organization
SUSQUEHANNA VALLEY DENTAL GROUP PC
Active
Organization
SUSQUEHANNA VALLEY DENTAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA SIMEONE-GILROY RDH (REGIONAL MANAGER)
(570) 655-7645
Entity
Organization
Contact information
Practice address
312 E MAIN ST, MIDDLEBURG, PA 17842-1106
(570) 837-5117
Mailing address
457 N MAIN ST STE 100, PITTSTON, PA 18640-2185
(570) 655-7645
(570) 299-7427
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/19/2019
Last updated
06/11/2019
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