Provider Demographics
NPI:1720297682
Name:ENDLESS MOUNTAINS DENTAL CARE PC
Entity Type:Organization
Organization Name:ENDLESS MOUNTAINS DENTAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:PASCOE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-578-1186
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-0367
Mailing Address - Country:US
Mailing Address - Phone:570-278-1186
Mailing Address - Fax:570-278-1873
Practice Address - Street 1:21 PUBLIC AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-0367
Practice Address - Country:US
Practice Address - Phone:570-278-1186
Practice Address - Fax:570-278-1873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017498122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty