Organization
KEYSTONE OMFS PC
Active
Other names
Susquehanna Oral & Facial Surgery & Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC S ROSENTHAL DMD MD (OWNER)
(570) 323-1900
Entity
Organization
Contact information
Practice address
1701 FOUR MILE DR, WILLIAMSPORT, PA 17701-1940
(570) 323-1900
(570) 323-6079
Mailing address
1701 FOUR MILE DR, WILLIAMSPORT, PA 17701-1940
(570) 323-1900
(570) 323-6079
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS029213L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699852137
NPI TYPE 1
PA
Enumeration date
10/21/2015
Last updated
10/21/2015
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