Organization
MOSHANNON VALLEY FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS AMY L BRITTON (RECEPTIONIST)
(814) 378-7479
Entity
Organization
Contact information
Practice address
439 SPRING ST, HOUTZDALE, PA 16651-1702
(814) 378-7479
(814) 378-7439
Mailing address
439 SPRING ST, HOUTZDALE, PA 16651-1702
(814) 378-7479
(814) 378-7439
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS029496L
PA
1223G0001X
General Practice Dentistry
DS031452L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015366400003
—
PA
05
—
0018194120002
—
PA
05
—
1015127030001
—
PA
01
—
927201
UNITED CONCORDIA
PA
Enumeration date
11/08/2006
Last updated
08/22/2020
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