Healthcare Provider Details

I. General information

NPI: 1235158346
Provider Name (Legal Business Name): DENTAL CARE ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 SYCAMORE RD
MONTOURSVILLE PA
17754-9314
US

IV. Provider business mailing address

1660 SYCAMORE RD
MONTOURSVILLE PA
17754-9314
US

V. Phone/Fax

Practice location:
  • Phone: 570-323-4819
  • Fax: 570-323-7057
Mailing address:
  • Phone: 570-323-4819
  • Fax: 570-323-7057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS017834L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS017834L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License NumberDS017834L
License Number StatePA

VIII. Authorized Official

Name: DR. HARRY AVES
Title or Position: STOCK HOLDER
Credential: DDS
Phone: 570-323-4819