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Organization
SUSQUEHANNA VALLEY DENTAL HEALTH ASSOCIATES
Active
Organization
SUSQUEHANNA VALLEY DENTAL HEALTH ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLAYTON ORLANDO PESILLO DMD (PARTNER)
(570) 742-9607
Entity
Organization
Contact information
Practice address
20 SCHOOLHOUSE RD, MILTON, PA 17847-7909
(570) 742-9607
Mailing address
20 SCHOOLHOUSE RD, MILTON, PA 17847-7909
(570) 742-9607
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS17696
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019642900001
—
PA
Enumeration date
02/26/2007
Last updated
08/22/2020
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