Provider Demographics
NPI:1871206714
Name:MOUNTAIN VIEW DENTAL PRACTICE ASSOCIATES
Entity type:Organization
Organization Name:MOUNTAIN VIEW DENTAL PRACTICE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, PHD
Authorized Official - Phone:724-832-1835
Mailing Address - Street 1:105 MEADOW SPRING RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6935
Mailing Address - Country:US
Mailing Address - Phone:724-832-1835
Mailing Address - Fax:
Practice Address - Street 1:105 MEADOW SPRING RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6935
Practice Address - Country:US
Practice Address - Phone:724-832-1835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty