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Individual

DR. VINCENT G DAUCHESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
401 W MARKET ST, POTTSVILLE, PA 17901-2930
(570) 622-2036
(570) 622-5242
Mailing address
401 W MARKET ST, POTTSVILLE, PA 17901-2930
(570) 622-2036
(570) 622-5242

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
DS018834-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005170230001
PA
01
01176001
CAPITAL BLUE CROSS
PA
01
0160922
KEYSTONE
PA
01
160922
BLUE SHIELD MEDICAL
PA
Enumeration date
02/01/2006
Last updated
07/08/2007
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