Individual
MRS. KAREN S PESILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHDHP
Contact information
Practice address
566 COUNTRY RD, LEWISBURG, PA 17837-7065
(412) 255-4672
Mailing address
566 COUNTRY RD, LEWISBURG, PA 17837-7065
(570) 490-5745
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH006260L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124Q00000X
—
PA
Enumeration date
12/27/2017
Last updated
12/27/2017
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