Organization
AFFILIATED PEDIATRIC DENTISTRY
Active
Organization
AFFILIATED PEDIATRIC DENTISTRY
Active
Other names
Ross M. Wezmar DDS PC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROSS M WEZMAR DDS PC (OWNER)
(570) 346-7760
Entity
Organization
Contact information
Practice address
313 MULBERRY ST, SCRANTON, PA 18503-1221
(570) 346-7760
(570) 346-9002
Mailing address
313 MULBERRY ST, SCRANTON, PA 18503-1221
(570) 346-7760
(570) 346-9002
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
17699
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005246180003
MEDICAL ASSISTANCE
PA
01
—
0005246180005
MEDICAL ASSISTANCE
PA
01
—
1013232140003
MEDICAL ASSISTANCE
PA
01
—
1013232140005
MEDICAL ASSISTANCE
PA
01
—
1023077430001
MEDICAL ASSISTANCE
PA
01
—
1023077430004
MEDICAL ASSISTANCE
PA
01
—
1024923650001
MEDICAL ASSISTANCE
PA
01
—
1024923650003
MEDICAL ASSISTANCE
PA
Enumeration date
08/17/2012
Last updated
01/18/2013
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