# CENTERVILLE CLINICS, INC.

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

## Provider details

- **NPI number:** 1932181047
- **Authorized official:** MRS. PATRICIA MARTOS (DIRECTOR FINANCE/PERSONNEL)
- **Authorized official phone:** (724) 632-6801

## Contact information

- **Practice address:** 1006 MAIN STREET, REPUBLIC, PA 15475
- **Practice address phone:** (724) 246-9434
- **Practice address fax:** (724) 246-9846
- **Mailing address:** 1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
- **Mailing address phone:** (724) 632-6801
- **Mailing address fax:** (724) 632-6840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 124Q00000X | Dental Hygienist | — | NULL | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 126800000X | Dental Assistant | — | NULL | — |
| 126800000X | Dental Assistant | — | — | — |

## Other

- **Enumeration date:** 11/15/2005
- **Last updated:** 04/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1007288440032 | — | PA |