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General NPI Number Information
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NPI Number | 1750548483
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Entity Type | Organization
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Legal Business Name | L. KEVIN METSGER
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 520 PELLIS RD SUITE 4000
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City | GREENSBURG
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State | PA
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Zip | 15601-4777
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Country | US
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Telephone | 724-837-5009
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Fax | 724-834-0106
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Provider Business Mailing Address
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Address Line | 520 PELLIS RD SUITE 4000
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City | GREENSBURG
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State | PA
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Zip | 15601-4777
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Country | US
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Telephone | 724-837-5009
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Fax | 724-834-0106
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Authorized Official
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Title or Position | BUSINESS ASSISTANT
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Name | TAMMY POTTER
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Credential |
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Telephone | 724-837-5009
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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 | DSO25334L
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License Number State | PA
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