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General NPI Number Information
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NPI Number | 1326135930
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Entity Type | Organization
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Legal Business Name | ACTION HEALTH DENTAL CLINIC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 335 MARKET STREET
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City | SUNBURY
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State | PA
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Zip | 17801
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Country | US
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Telephone | 570-988-0778
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Fax | 570-286-4788
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Provider Business Mailing Address
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Address Line | 335 MARKET STREET
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City | SUNBURY
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State | PA
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Zip | 17801
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Country | US
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Telephone | 570-988-0778
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Fax | 570-286-4788
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. ALLISON DOREEN CLARK
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Credential |
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Telephone | 570-988-0735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State | PA
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