MEDICARE: GRANDVIEW DENTAL, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	021893	PA

General Provider Information

NPI Number	:	1023141181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRANDVIEW DENTAL, P.C.

Provider Business Mailing Address
First Line	:	116 E GRANDVIEW AVE
Second Line	:
City	:	ZELIENOPLE
State	:	PA
Zip	:	16063-1131
Country	:	US
Telephone Number	:	724-452-6020
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 E GRANDVIEW AVE
Second Line	:
City	:	ZELIENOPLE
State	:	PA
Zip	:	16063-1131
Country	:	US
Telephone Number	:	724-452-6020
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KORWIN KING
Credential	:	DDS
Telephone Number	:	724-452-6020

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	10/15/2008

Similar Medicare Providers

1932191418 — KORWIN KING D.D.S.
Practice Location Address:

116 E GRANDVIEW AVE
ZELIENOPLE, PA
16063-1131

Practice Phone: 724-452-6020
Practice Fax: 724-452-8317

1124854336 — VICTORIA MCWILLIAMS DOULA
Practice Location Address:

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Practice Fax:

1306844295 — PASSAVANT RETIREMENT AND HEALTH CENTER
Practice Location Address:

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1497754980 — DR. MARK EDWARD FLEMING D.C.
Practice Location Address:

438 S MAIN ST
ZELIENOPLE, PA
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1518969047 — GERALD G. SOLTIS O.D.
Practice Location Address:

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1063451540 — DR. DENNIS D HAMILTON D.D.S.
Practice Location Address:

214 W GRANDVIEW AVE
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16063-1137

Practice Phone: 724-452-7960
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