Organization
BAMONTE ORAL SURGERY CRNA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A BAMONTE DMD (OWNER)
(724) 934-3844
Entity
Organization
Contact information
Practice address
101 N MEADOWS DR, SUITE #121, WEXFORD, PA 15090-8368
(724) 394-3844
(724) 394-3851
Mailing address
101 N MEADOWS DR, SUITE #121, WEXFORD, PA 15090-8368
(724) 394-3844
(724) 394-3851
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS024033L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1444788
BCBS PROVIDER NUMBER
PA
Enumeration date
02/09/2007
Last updated
08/22/2020
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