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General NPI Number Information
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NPI Number | 1720479637
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Entity Type | Organization
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Legal Business Name | TIMOTHY MARK OPIEL DENTISTRY LLC
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 34 S MAIN ST
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City | PITTSTON
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State | PA
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Zip | 18640-1827
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Country | US
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Telephone | 570-654-2484
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Fax | 570-654-4867
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Provider Business Mailing Address
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Address Line | 34 S MAIN ST
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City | PITTSTON
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State | PA
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Zip | 18640-1827
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Country | US
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Telephone | 570-654-2484
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Fax | 570-654-4867
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY MARK OPIEL
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Credential | DMD
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Telephone | 570-654-2484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS038284
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License Number State | PA
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