| Philipsburg Family Dentistry | |
|
109 N Centre St Philipsburg PA 16866-1661 | |
| (814) 342-1101 | |
| Not Available |
| Full Name | Philipsburg Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 109 N Centre St, Philipsburg, Pennsylvania |
| Authorized Official Name and Position | Jolene J Gavlak-vaughn (OWNER) |
| Authorized Official Contact | 8145575114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philipsburg Family Dentistry Po Box 60 Philipsburg PA 16866-0060 Ph: (814) 342-1101 | Philipsburg Family Dentistry 109 N Centre St Philipsburg PA 16866-1661 Ph: (814) 342-1101 |
| NPI Number | 1912172263 |
|---|---|
| Provider Enumeration Date | 04/28/2008 |
| Last Update Date | 01/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912172263 | NPI | - | NPPES |
| 001819412 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS031452L (Pennsylvania) | Primary |
Gabriel T. Mancuso, Dmd Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Front St, Philipsburg, PA 16866 Phone: 814-342-1090 Fax: 814-343-2597 |