Organization
CHARLES G.SHEA,DMD,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE M. SHEA (PRACTICE MANAGER)
(814) 535-7888
Entity
Organization
Contact information
Practice address
225 VINE ST, JOHNSTOWN, PA 15901-1518
(814) 535-7888
(814) 539-8858
Mailing address
225 VINE ST, JOHNSTOWN, PA 15901-1518
(814) 535-7888
(814) 539-8858
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015391880001
—
PA
Enumeration date
07/15/2013
Last updated
07/15/2013
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