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General NPI Number Information
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NPI Number | 1497514343
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Entity Type | Organization
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Legal Business Name | WYOMING VALLEY ORTHODONTICS
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 40 MAIN ST
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City | DALLAS
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State | PA
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Zip | 18612-1804
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Country | US
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Telephone | 570-674-7474
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Fax |
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Provider Business Mailing Address
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Address Line | 40 MAIN ST
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City | DALLAS
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State | PA
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Zip | 18612-1804
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Country | US
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Telephone | 570-674-7474
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL J ADAMS
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Credential | DDS
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Telephone | 570-674-7474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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