| Elizabeth L Wakim Dds Llc | |
|
604 N Main St Washington PA 15301-3912 | |
| (724) 225-5070 | |
| (724) 225-5262 |
| Full Name | Elizabeth L Wakim Dds Llc |
|---|---|
| Speciality | Dentist |
| Location | 604 N Main St, Washington, Pennsylvania |
| Authorized Official Name and Position | Elizabeth L Wakim (PRESIDENT) |
| Authorized Official Contact | 7242255070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth L Wakim Dds Llc 604 N Main St Washington PA 15301-3912 Ph: (724) 225-5070 | Elizabeth L Wakim Dds Llc 604 N Main St Washington PA 15301-3912 Ph: (724) 225-5070 |
| NPI Number | 1659865376 |
|---|---|
| Provider Enumeration Date | 06/16/2018 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 4587909197 |
|---|---|
| Medicare Enrollment ID | O20181228001601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659865376 | NPI | - | NPPES |
| 1030002210001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Elizabeth L Wakim |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1689016339 PECOS PAC ID: 8123363819 Enrollment ID: I20181228002056 |
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