Organization
JOHNSONBURG DENTAL CENTER
Active
Parent organization
KEYSTONE RURAL HEALTH CONSORTIA INC
Other names
Keystone Rural Health Consortia, Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEYSTONE RURAL HEALTH CONSORTIA INC
Authorized official
KRISTIE M BENNARDI (CEO)
(814) 486-1115
Entity
Organization
Contact information
Practice address
81 CLARION RD, JOHNSONBURG, PA 15845-1656
(814) 965-5444
(814) 965-2238
Mailing address
81 CLARION RD, JOHNSONBURG, PA 15845-1656
(814) 965-5444
(814) 965-2238
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/29/2006
Last updated
12/16/2019
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