Organization
VALLEY ORAL SURGEON, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L.. DELROSARIO D.D.S. (OWNER)
(814) 536-4675
Entity
Organization
Contact information
Practice address
20 OSBORNE ST, JOHNSTOWN, PA 15905-4128
(814) 536-4675
(814) 536-8897
Mailing address
20 OSBORNE ST, JOHNSTOWN, PA 15905-4128
(814) 536-4675
(814) 536-8897
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS028079L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102928
UPMC PIN
PA
01
—
VA112926
HIGHMARK GROUP PRACTICE
PA
Enumeration date
06/19/2006
Last updated
08/22/2020
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