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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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