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NPI Code Detail

MEDICARE: DR. SAMUEL MICHAEL PRISCO DDS

MEDICARE: DR. SAMUEL MICHAEL PRISCO DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDS022580LPA

General Provider Information

NPI Number : 1730241894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL MICHAEL PRISCO DDS
Provider Business Mailing Address
First Line : 444 ORCHARD ST
Second Line :
City : SCRANTON
State : PA
Zip : 18505-1257
Country : US
Telephone Number : 570-342-7868
Fax Number :
Provider Business Practice Location Address
First Line : 5 S WASHINGTON AVE
Second Line :
City : JERMYN
State : PA
Zip : 18433-1121
Country : US
Telephone Number : 570-230-0019
Fax Number : 570-230-0013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 01/19/2026

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