Provider Demographics
NPI:1770772972
Name:WHITE OAK DENTAL ASSOCIATES
Entity type:Organization
Organization Name:WHITE OAK DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:VARGO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-664-1112
Mailing Address - Street 1:1220 LINCOLN WAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WHITE OAK
Mailing Address - State:PA
Mailing Address - Zip Code:15131
Mailing Address - Country:US
Mailing Address - Phone:412-664-1112
Mailing Address - Fax:412-678-4564
Practice Address - Street 1:1220 LINCOLN WAY
Practice Address - Street 2:SUITE 202
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15131-1642
Practice Address - Country:US
Practice Address - Phone:412-664-1112
Practice Address - Fax:412-678-4564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021008L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty