Individual
ELISSA DIANE COLLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2217 7TH AVE, ALTOONA, PA 16602-2243
(814) 931-9111
Mailing address
1818 2ND AVE, ALTOONA, PA 16602-3558
(814) 232-7464
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS041316
PA
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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