Back Mountain Dental, Inc.
NPI #1245301381 in Trucksville, Pennsylvania
Provider Information
- NPI Number
- 1245301381
- Entity Type
- Organization
- Organization Name
- Back Mountain Dental, Inc.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 12, 2006
- Last Updated
- Nov 4, 2009
Practice Location
- Address
- 210 CARVERTON RD
- City
- Trucksville
- State
- Pennsylvania
- ZIP Code
- 18708-1745
- Phone
- (570) 696-1105
Authorized Official
- Name
- DR. JAMES CLEMENS DEFINNIS, D.M.D
- Title
- PRESIDENT
- Phone
- (570) 696-1105
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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