Organization
POCONO ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA NILES (RECEPTIONIST)
(570) 253-4000
Entity
Organization
Contact information
Practice address
1095 TEXAS PALMYRA HWY, SUITE M, HONESDALE, PA 18431-7672
(570) 253-4000
Mailing address
1095 TEXAS PALMYRA HWY, SUITE M, HONESDALE, PA 18431-7672
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
BL5871187
PA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
DS020813L
PA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
DS035287
PA
Other
Enumeration date
06/14/2007
Last updated
07/25/2007
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