Individual
DR. RUSSELL T. WIBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
689 N HERMITAGE RD, HERMITAGE, PA 16148-3203
(724) 981-4222
(724) 981-4228
Mailing address
689 N HERMITAGE RD, HERMITAGE, PA 16148-3203
(724) 981-4222
(724) 981-4228
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DS027889L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000325486
ANTHEM
OH
01
—
204563
UPMC
PA
01
—
419683
BC/BS
PA
01
—
HMO2375673
AETNA
PA
01
—
PPO4420848
AETNA
PA
Enumeration date
01/29/2008
Last updated
01/22/2025
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