Indiana Regional Medical Center

Organization Dental Clinic/Center · NPI 1770614919

Indiana Regional Medical Center provides Dental Clinic/Center services in Indiana, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2007.

Licensed in: PA
In the registry since: 2007

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Practice location Address checks out

835 Hospital Road Pediatric & Adolescent Dental Clinic
Indiana, PA 15701-0788
Phone: (724) 357-6960
Fax: (724) 357-6961

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary)	Taxonomy 261QD0000X · Licence 090701 (PA)

Record details

NPI number	1770614919
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Michael Ickowski — Chief Financial Officer · (724) 357-7008
NPI enumerated	March 8, 2007
Last updated in NPPES	July 10, 2024
Certification date	July 10, 2024
Mailing address	835 Hospital Road, Po Box 788, Indiana, PA 15701-0788