Individual
KEVIN ROBERT MECCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
707 NORTH STATE STREET, CLARKS SUMMIT, PA 18411
(570) 586-2979
(570) 586-2107
Mailing address
707 NORTH STATE STREET, CLARKS SUMMIT, PA 18411
(570) 586-2979
(570) 586-2107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
028260L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110499
PA BCBS
PA
Enumeration date
02/21/2008
Last updated
02/21/2008
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