Provider Demographics
NPI:1033471412
Name:COMMUNITY HEALTH SERVICES
Entity Type:Organization
Organization Name:COMMUNITY HEALTH SERVICES
Other - Org Name:MEADVILLE DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-373-2449
Mailing Address - Street 1:640 ALDEN ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2348
Mailing Address - Country:US
Mailing Address - Phone:814-373-5200
Mailing Address - Fax:814-373-5205
Practice Address - Street 1:640 ALDEN ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2348
Practice Address - Country:US
Practice Address - Phone:814-373-5200
Practice Address - Fax:814-373-5205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEADVILLE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-12
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty