Organization
PINNACLE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH G MILLER DDS (PRESIDENT)
(570) 586-5300
Entity
Organization
Contact information
Practice address
233 NORTHERN BLVD, SUITE 5, CLARKS SUMMIT, PA 18411-8720
(570) 586-5300
(570) 586-4720
Mailing address
233 NORTHERN BLVD, SUITE 5, CLARKS SUMMIT, PA 18411-8720
(570) 586-5300
(570) 586-4720
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000938910
—
PA
Enumeration date
05/10/2007
Last updated
03/22/2013
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