Organization
CAVALANCIA ORTHODONTIC GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY A CAVALANCIA DDS, MSDD (OWNER/DOCTOR)
(724) 463-7700
Entity
Organization
Contact information
Practice address
152 N 5TH ST, INDIANA, PA 15701-1983
(724) 463-7700
(724) 463-7738
Mailing address
152 N 5TH ST, INDIANA, PA 15701-1983
(724) 463-7700
(724) 463-7738
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS023571L
PA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DS039961
PA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DS041199
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024481510001
—
PA
Enumeration date
05/02/2018
Last updated
05/02/2018
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