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Organization

MCKEES ROCKS DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON FEDERER (OWNER)
(727) 463-8284
Entity
Organization

Contact information

Practice address
757 CHARTIERS AVE, MC KEES ROCKS, PA 15136-3622
(412) 331-4629
Mailing address
PO BOX 66, HOUSTON, PA 15342-0066

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103099940-0001
PA
Enumeration date
03/21/2017
Last updated
03/21/2017
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