MEDICARE: COTTURO DENTAL ASSOCIATES

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	122300000X	Dentist	DS015065-L	PA

General Provider Information

NPI Number	:	1568674935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COTTURO DENTAL ASSOCIATES

Provider Business Mailing Address
First Line	:	2094 S DELAWARE DR
Second Line	:
City	:	MOUNT BETHEL
State	:	PA
Zip	:	18343-5240
Country	:	US
Telephone Number	:	570-897-5422
Fax Number	:	570-897-5424

Provider Business Practice Location Address
First Line	:	2094 S DELAWARE DR
Second Line	:
City	:	MOUNT BETHEL
State	:	PA
Zip	:	18343-5240
Country	:	US
Telephone Number	:	570-897-5422
Fax Number	:	570-897-5424

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PALMER J COTTURO
Credential	:	DDS
Telephone Number	:	570-897-5422

Provider Enumeration Date	:	05/05/2007
Last Update Date	:	07/17/2013

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