Nepa Dental Group, INC

NPI #1669082632 in Forty Fort, Pennsylvania

Provider Information

NPI Number: 1669082632
Entity Type: Organization
Organization Name: Nepa Dental Group, INC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 5, 2020
Last Updated: Aug 5, 2020

Practice Location

Address: 920 WYOMING AVE STE 104
City: Forty Fort
State: Pennsylvania
ZIP Code: 18704-3970
Phone: (570) 283-2422

Authorized Official

Name: JOHN ALBERT COSTELLO, DMD
Title: VICE PRESIDENT
Phone: (570) 655-7645

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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