Organization
JOHN W. CLEMENZA, DMD, MD ORAL AND FACIAL SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILLIAM CLEMENZA D.M.D., M.D. (MEMBER)
(724) 981-8884
Entity
Organization
Contact information
Practice address
3041 INNOVATION WAY, HERMITAGE, PA 16148
(724) 981-8884
Mailing address
3041 INNOVATION WAY, HERMITAGE, PA 16148
(724) 981-8884
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
974553
BC/ BS
PA
Enumeration date
05/04/2006
Last updated
03/17/2008
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