Organization
HOSTETLER FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY DAWN HOSTETLER DDS (DENTIST)
(724) 438-7676
Entity
Organization
Contact information
Practice address
665 CHERRY TREE LN, #B, UNIONTOWN, PA 15401-8947
(724) 438-7676
(724) 438-3060
Mailing address
665 CHERRY TREE LN, #B, UNIONTOWN, PA 15401-8947
(724) 438-7676
(724) 438-3060
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS030210L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018764910001
—
PA
01
—
030210
DELTA
PA
01
—
963585
BCBS
PA
Enumeration date
08/03/2006
Last updated
08/22/2020
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