Cda Lake Winola LLC
NPI #1104491653 in Factoryville, Pennsylvania
Provider Information
- NPI Number
- 1104491653
- Entity Type
- Organization
- Organization Name
- Cda Lake Winola LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- CDA LAKE WINOLA LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 26, 2021
- Last Updated
- May 26, 2021
Practice Location
- Address
- 1220 PA-307
- City
- Factoryville
- State
- Pennsylvania
- ZIP Code
- 18419
- Phone
- (570) 378-3305
Authorized Official
- Name
- DR. JASON J HANYON, DMD
- Title
- OWNER
- Phone
- (570) 378-3305
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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