Organization
VINCENT G. DAUCHESS, D.D.S, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT G. DAUCHESS D.D.S (PROPRIETER)
(570) 622-2036
Entity
Organization
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
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS018834-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012807780002
—
PA
01
—
02340400
CAPITAL BLUE CROSS
PA
01
—
529243
ATENA
PA
01
—
614756
BLUE SHIELD MEDICAL
PA
01
—
A60922
AMERIHEALTH
PA
Enumeration date
11/09/2006
Last updated
11/07/2007
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