Provider Demographics
NPI:1053473314
Name:DELANEY, PAGE W (DDS)
Entity Type:Individual
Prefix:
First Name:PAGE
Middle Name:W
Last Name:DELANEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9510 LINCOLN HIGHWAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522
Mailing Address - Country:US
Mailing Address - Phone:814-623-9202
Mailing Address - Fax:814-623-1633
Practice Address - Street 1:9510 LINCOLN HIGHWAY
Practice Address - Street 2:SUITE 1
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522
Practice Address - Country:US
Practice Address - Phone:814-623-9202
Practice Address - Fax:814-623-1633
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015575L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice