| Centerville Clinics, Inc. | |
|
1006 Main Street Republic PA 15475 | |
| (724) 246-9434 | |
| (724) 246-9846 |
| Full Name | Centerville Clinics, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1006 Main Street, Republic, Pennsylvania |
| Authorized Official Name and Position | Patricia Martos (DIRECTOR FINANCE/PERSONNEL) |
| Authorized Official Contact | 7246326801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerville Clinics, Inc. 1070 Old National Pike Fredericktown PA 15333-2114 Ph: (724) 632-6801 | Centerville Clinics, Inc. 1006 Main Street Republic PA 15475 Ph: (724) 246-9434 |
| NPI Number | 1932181047 |
|---|---|
| Provider Enumeration Date | 11/15/2005 |
| Last Update Date | 04/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932181047 | NPI | - | NPPES |
| 1007288440032 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 124Q00000X | Dental Hygienist | (* (Not Available)) | Secondary |
| 126800000X | Dental Assistant | (* (Not Available)) | Secondary |