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DAVIDSON- TUCKER ORAL SURGERY ASSOCIATES NPI 1629007505


NPI Information

NPI: 1629007505
Provider Name: DAVIDSON- TUCKER ORAL SURGERY ASSOCIATES
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
17 ARENTZEN BLVD
SUITE #104
CHARLEROI, PA
ZIP 15022
Phone: (724) 483-5080
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DAVIDSON- TUCKER ORAL SURGERY ASSOCIATES is an oral and maxillofacial surgery dentist in Charleroi, PA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DAVIDSON- TUCKER ORAL SURGERY ASSOCIATES NPI is 1629007505. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

17 ARENTZEN BLVD
SUITE #104
CHARLEROI, PA
ZIP 15022-085
Phone: (724) 483-5080
Fax: (724) 483-3760

The provider's authorized official is Charles Peter Tucker .
The authorized official title is President, Davidson-tucker Oral Sur and has the following contact phone number (724) 483-5080.

The enumeration date for this NPI number is 7/2/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryDS026650-LPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10525357MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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