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Individual

DR. RONALD RICHARD MANGLAVITI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
ROUTE 307, LAKE WINOLA, PA 18625-0335
(570) 378-3305
(570) 378-3430
Mailing address
PO BOX 335, LAKE WINOLA, PA 18625-0335
(570) 378-3305
(570) 378-3430

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS030229L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
980879
UNITED CONCORDIA
PA
Enumeration date
03/08/2007
Last updated
07/08/2007
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