# BROWN-MCMULLEN-WISSE DENTAL ASSOCIATES, PC.

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

## Provider details

- **NPI number:** 1912121427
- **Authorized official:** MATTHEW JOSEPH COSTA D.M.D. (OWNER)
- **Authorized official phone:** (717) 786-2746

## Contact information

- **Practice address:** 316 W 4TH ST, QUARRYVILLE, PA 17566-1138
- **Practice address phone:** (717) 786-2746
- **Practice address fax:** (717) 786-4872
- **Mailing address:** 316 W 4TH ST, QUARRYVILLE, PA 17566-1138
- **Mailing address phone:** (717) 786-2746
- **Mailing address fax:** (717) 786-4872

## Taxonomy

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

## Other

- **Enumeration date:** 04/13/2007
- **Last updated:** 02/14/2019