| Family Dental Practice P.c. Inc. | |
|
213 E Market St Wilkes Barre PA 18702-5234 | |
| (570) 825-9645 | |
| (570) 822-6477 |
| Full Name | Family Dental Practice P.c. Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 213 E Market St, Wilkes Barre, Pennsylvania |
| Authorized Official Name and Position | William E. Walthour (PRESIDENT/DENTIST) |
| Authorized Official Contact | 5708259645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Practice P.c. Inc. 213 E Market St Wilkes Barre PA 18702-5234 Ph: (570) 825-9645 | Family Dental Practice P.c. Inc. 213 E Market St Wilkes Barre PA 18702-5234 Ph: (570) 825-9645 |
| NPI Number | 1144284415 |
|---|---|
| Provider Enumeration Date | 04/13/2006 |
| Last Update Date | 09/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144284415 | NPI | - | NPPES |
| 42310 | Other | PA | UNITED CONCORDIA PROVIDER |
| 0005261110001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS019268L (Pennsylvania) | Primary |
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