Organization
MICHAEL V. JACONSKI, DMD,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL V. JACONSKI DMD (OWNER)
(412) 486-6777
Entity
Organization
Contact information
Practice address
4000 MOUNT ROYAL BLVD, ALLISON PARK, PA 15101-2918
(412) 486-6777
(412) 487-8161
Mailing address
4000 MOUNT ROYAL BLVD, ALLISON PARK, PA 15101-2918
(412) 486-6777
(412) 487-8161
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS025964L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1587105
UNITED CONCORDIA
PA
Enumeration date
10/26/2006
Last updated
08/22/2020
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