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Organization

CHARLES G SHEA DMD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES G SHEA DMD (OWNER)
(814) 535-7888
Entity
Organization

Contact information

Practice address
225 VINE ST, JOHNSTOWN, PA 15901
(814) 535-7888
(814) 539-8858
Mailing address
225 VINE ST, JOHNSTOWN, PA 15901
(814) 535-7888
(814) 539-8858

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS-018700-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015391880001
PA
01
160535
BS
PA
Enumeration date
02/13/2007
Last updated
09/19/2013
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