Provider Demographics
NPI:1598926131
Name:VOLLER DENTISTRY
Entity Type:Organization
Organization Name:VOLLER DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-543-4948
Mailing Address - Street 1:135 N GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-1445
Mailing Address - Country:US
Mailing Address - Phone:724-543-4948
Mailing Address - Fax:
Practice Address - Street 1:135 N GRANT AVE
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-1445
Practice Address - Country:US
Practice Address - Phone:724-543-4948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty