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General NPI Number Information
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NPI Number | 1922790336
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Entity Type | Individual
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Provider Name | CAROLYN GRACE SERIO DMD
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Gender | Female
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 517 NORTHERN BLVD
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9024
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Country | US
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Telephone | 570-587-1196
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Fax |
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Provider Business Mailing Address
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Address Line | 117 OAK HILL DR
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City | ARCHBALD
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State | PA
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Zip | 18403-1556
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Country | US
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Telephone | 570-955-7038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS043181
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License Number State | PA
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