| Keystone Dental Mont Alto | |
|
6155 Anthony Hwy Ste C Waynesboro PA 17268-9718 | |
| (717) 765-8664 | |
| (717) 765-8663 |
| Full Name | Keystone Dental Mont Alto |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 6155 Anthony Hwy Ste C, Waynesboro, Pennsylvania |
| Authorized Official Name and Position | Holly Weaver (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7177097922 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keystone Dental Mont Alto 111 Chambers Hill Dr Ste 200 Chambersburg PA 17201-7304 Ph: (717) 709-7922 | Keystone Dental Mont Alto 6155 Anthony Hwy Ste C Waynesboro PA 17268-9718 Ph: (717) 765-8664 |
| NPI Number | 1275055873 |
|---|---|
| Provider Enumeration Date | 07/14/2017 |
| Last Update Date | 01/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275055873 | NPI | - | NPPES |
| 100776233 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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