Organization
ELIZABETH L WAKIM DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH L WAKIM DDS (PRESIDENT)
(724) 225-5070
Entity
Organization
Contact information
Practice address
604 N MAIN ST, WASHINGTON, PA 15301-3912
(724) 225-5070
(724) 225-5262
Mailing address
604 N MAIN ST, WASHINGTON, PA 15301-3912
(724) 225-5070
(724) 225-5262
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030002210001
—
PA
Enumeration date
06/16/2018
Last updated
06/16/2018
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