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General NPI Number Information
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NPI Number | 1104995646
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Entity Type | Organization
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Legal Business Name | JEANNETTE DENTAL CENTER INC.
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 500 HARRISON AVE
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City | JEANNETTE
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State | PA
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Zip | 15644-1915
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Country | US
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Telephone | 724-523-5551
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Fax | 724-523-4738
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Provider Business Mailing Address
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Address Line | 500 HARRISON AVE
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City | JEANNETTE
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State | PA
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Zip | 15644-1915
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Country | US
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Telephone | 724-523-5551
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Fax | 724-523-4738
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS PAUL MARCELLI
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Credential | DDS
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Telephone | 724-523-5551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS023747L
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License Number State | PA
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