| La Dental Inc Levi Evalt Dds Dental Excellence | |
|
209 N Center St Corry PA 16407-1626 | |
| (814) 664-2012 | |
| (814) 964-4055 |
| Full Name | La Dental Inc Levi Evalt Dds Dental Excellence |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 209 N Center St, Corry, Pennsylvania |
| Authorized Official Name and Position | Levi Robert Evalt (OWNER) |
| Authorized Official Contact | 8146642012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Dental Inc Levi Evalt Dds Dental Excellence 209 N Center St Corry PA 16407-1626 Ph: (814) 664-2012 | La Dental Inc Levi Evalt Dds Dental Excellence 209 N Center St Corry PA 16407-1626 Ph: (814) 664-2012 |
| NPI Number | 1114523487 |
|---|---|
| Provider Enumeration Date | 12/10/2020 |
| Last Update Date | 12/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114523487 | NPI | - | NPPES |
| 001967890 | Medicaid | PA | |
| 000870813 | Medicaid | PA | |
| 102543929 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Healthy Smiles Of Corry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 983 N Center St, Corry, PA 16407 Phone: 814-664-4011 Fax: 814-664-9376 | |
Affordable Smiles Of Corry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 N Center St, Corry, PA 16407 Phone: 814-664-2012 Fax: 814-664-2017 | |
Affordable Smiles Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 N Center St, Corry, PA 16407 Phone: 814-664-2012 Fax: 814-664-2017 |