Organization
ASPEN DENTAL OF SW PENNSYLVANIA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BERTOLLINI (PRS)
(866) 273-8204
Entity
Organization
Contact information
Practice address
121 TOWN CENTRE DR, JOHNSTOWN, PA 15904-2824
(814) 266-5141
(814) 266-5919
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(866) 273-8204
(315) 410-5531
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/01/2015
Last updated
05/01/2015
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