Healthcare Provider Details

I. General information

NPI: 1578497152
Provider Name (Legal Business Name): ORTHODONTICS UNLIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 PA-739
DINGMANS FERRY PA
18328
US

IV. Provider business mailing address

1409 PA-739
DINGMANS FERRY PA
18328
US

V. Phone/Fax

Practice location:
  • Phone: 570-287-2007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA R ABOD
Title or Position: OWNER
Credential:
Phone: 570-287-2007