MEDICARE: CORE ENDODONTICS PLLC

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	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1821736828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE ENDODONTICS PLLC

Provider Business Mailing Address
First Line	:	507 VILLA DR
Second Line	:
City	:	VENETIA
State	:	PA
Zip	:	15367-2387
Country	:	US
Telephone Number	:	856-912-9600
Fax Number	:

Provider Business Practice Location Address
First Line	:	8954 HILL DR
Second Line	:
City	:	NORTH HUNTINGDON
State	:	PA
Zip	:	15642-3112
Country	:	US
Telephone Number	:	724-237-5009
Fax Number	:

Authorized Official
Title or Position	:	ENDODONTIST, MEMBER
Name	:	DR. REBECCA WATKINS
Credential	:	DMD
Telephone Number	:	724-237-5009

Provider Enumeration Date	:	05/20/2022
Last Update Date	:	05/20/2022

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