Provider Demographics
NPI:1811766298
Name:WATSONTOWN DENTAL
Entity type:Organization
Organization Name:WATSONTOWN DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:VITUNAC
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-245-8765
Mailing Address - Street 1:315 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MIFFLINBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17844-1309
Mailing Address - Country:US
Mailing Address - Phone:570-245-8765
Mailing Address - Fax:
Practice Address - Street 1:151 MAIN ST
Practice Address - Street 2:
Practice Address - City:WATSONTOWN
Practice Address - State:PA
Practice Address - Zip Code:17777-1706
Practice Address - Country:US
Practice Address - Phone:570-538-5533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID E. VITUNAC D.M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice