Individual
JACK D DEPNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
710 THOMPSON AVENUE, STO ROX FAMILY HEALTH CENTER, MCKEES ROCKS, PA 15136
(412) 771-6462
(412) 771-5887
Mailing address
710 THOMPSON AVENUE, MCKEES ROCKS, PA 15136
(412) 771-6462
(412) 771-5887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS024335L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009781380002
—
PA
Enumeration date
06/06/2006
Last updated
07/08/2007
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