Individual
ANNETTE CONSTANCE THEOFILOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
255 CHARLESTON RD, SHARPSVILLE, PA 16150-3303
(724) 962-0403
Mailing address
2213 SHENANGO VALLEY FWY, HERMITAGE, PA 16148-2544
(724) 346-5173
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.020094
OH
1223G0001X
General Practice Dentistry
DS028955L
PA
Other
Enumeration date
07/13/2006
Last updated
01/31/2023
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