Organization
CDA LAKE WINOLA LLC
Active
Parent organization
CDA LAKE WINOLA LLC
Other names
Century Dental Lake Winola
Organization subpart
Yes
Provider details
NPI number
Legal business name
CDA LAKE WINOLA LLC
Authorized official
DR. JASON J HANYON DMD (OWNER)
(570) 378-3305
Entity
Organization
Contact information
Practice address
1220 PA-307, FACTORYVILLE, PA 18419
(570) 378-3305
(570) 378-3430
Mailing address
1220 PA-307, FACTORYVILLE, PA 18419
(570) 378-3305
(570) 378-3430
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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