Organization
PEDIATRIC DENTAL CARE PC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT L KILARESKI DDS (DENTIST)
(814) 238-7120
Entity
Organization
Contact information
Practice address
1019 GHANER RD STE 100, PORT MATILDA, PA 16870-7201
(814) 238-7120
(814) 238-2981
Mailing address
1019 GHANER RD STE 100, PORT MATILDA, PA 16870-7201
(814) 238-7120
(814) 238-2981
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
DS-019843-L
PA
1223P0221X
Pediatric Dentistry
Primary
DS-031216-L
PA
1223P0221X
Pediatric Dentistry
DS-036188-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015435680001
—
PA
Enumeration date
11/08/2006
Last updated
02/15/2016
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