Organization
BEAVER VALLEY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA CIARIMBOLI (REGIONAL MANAGER)
(724) 266-2099
Entity
Organization
Contact information
Practice address
546 MERCHANT ST, AMBRIDGE, PA 15003-2463
(724) 266-2099
(724) 266-5388
Mailing address
546 MERCHANT ST, AMBRIDGE, PA 15003-2463
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS030094L
PA
1223G0001X
General Practice Dentistry
DS036432
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017686540006
—
PA
05
—
1018235160001
—
PA
Enumeration date
10/31/2007
Last updated
10/31/2007
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