# PHILIPSBURG FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1912172263
- **Authorized official:** DR. JOLENE J GAVLAK-VAUGHN D.D.S. (OWNER)
- **Authorized official phone:** (814) 557-5114

## Contact information

- **Practice address:** 109 N CENTRE ST, PHILIPSBURG, PA 16866-1661
- **Practice address phone:** (814) 342-1101
- **Mailing address:** PO BOX 60, PHILIPSBURG, PA 16866-0060
- **Mailing address phone:** (814) 342-1101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS031452L | PA | Yes |

## Other

- **Enumeration date:** 04/28/2008
- **Last updated:** 01/28/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001819412 | — | PA |