Individual
EDWARD L DEMARTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
30 W MARKET ST, BLAIRSVILLE, PA 15717-1328
(724) 459-6340
(724) 459-6922
Mailing address
30 W MARKET ST, BLAIRSVILLE, PA 15717-1328
(724) 459-6340
(724) 459-6922
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-029130-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
597230
UNITED CONCORDIA
PA
05
—
76779
—
PA
Enumeration date
04/18/2007
Last updated
07/09/2007
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