Healthcare Provider Details
I. General information
NPI: 1639081169
Provider Name (Legal Business Name): MOHNEY DENTAL MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 HOSPITAL AVE
DU BOIS PA
15801-1439
US
IV. Provider business mailing address
101 HOSPITAL AVE
DU BOIS PA
15801-1439
US
V. Phone/Fax
- Phone: 814-375-1023
- Fax:
- Phone: 814-375-1023
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name: DR.
NICHOLAS
J
MOHNEY
Title or Position: OWNER
Credential: DMD
Phone: 814-771-0288