Organization
SULLIVAN COUNTY ACTION,INC.
Active
Other names
Sullivan County Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES C ROGERS (PRESIDENT)
(570) 946-4107
Entity
Organization
Contact information
Practice address
217 KING STREET, LAPORTE, PA 18626
(570) 946-5101
(570) 946-4341
Mailing address
PO BOX 1, LAPORTE, PA 18626-0001
(570) 946-4107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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