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General NPI Number Information
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NPI Number | 1750683363
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Entity Type | Organization
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Legal Business Name | YOUNG & SPECIAL DENTAL, PC
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 12/02/2010
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Provider Practice Location Address
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Address Line | 2790 W CHESTNUT ST
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City | WASHINGTON
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State | PA
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Zip | 15301-2542
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Country | US
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Telephone | 724-321-3544
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Fax |
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Provider Business Mailing Address
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Address Line | 2790 W CHESTNUT ST
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City | WASHINGTON
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State | PA
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Zip | 15301-2542
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Country | US
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Telephone | 724-321-3544
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SARAH ELIZABETH CLARK
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Credential |
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Telephone | 724-321-3544
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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 | DS037734
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License Number State | PA
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