Organization
TIOGA DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALICIA ANNE RISNER-BAUMAN DDS, FADPD (DENTAL CLINIC DIRECTOR)
(570) 827-0145
Entity
Organization
Contact information
Practice address
34 E LAWRENCE RD, LAWRENCEVILLE, PA 16929-8801
(570) 724-9145
(570) 724-5397
Mailing address
34 E LAWRENCE RD, LAWRENCEVILLE, PA 16929-8801
(570) 724-9145
(570) 724-5397
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2009
Last updated
06/08/2015
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