Provider Demographics
NPI:1104040419
Name:PHILIP J LOSCO DMD PC
Entity Type:Organization
Organization Name:PHILIP J LOSCO DMD PC
Other - Org Name:DELMONT DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOSCO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-468-3386
Mailing Address - Street 1:6518 STATE ROUTE 22
Mailing Address - Street 2:SALEM 22 PLAZA
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-2410
Mailing Address - Country:US
Mailing Address - Phone:724-468-3386
Mailing Address - Fax:
Practice Address - Street 1:6518 STATE ROUTE 22
Practice Address - Street 2:SALEM 22 PLAZA
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626-2410
Practice Address - Country:US
Practice Address - Phone:724-468-3386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 024655-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty