Provider Demographics
NPI:1760503064
Name:FAMILY DENTAL AND HYGIENE CENTER
Entity type:Organization
Organization Name:FAMILY DENTAL AND HYGIENE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:POLIT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-655-7645
Mailing Address - Street 1:457 NORTH MAIN ST.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640
Mailing Address - Country:US
Mailing Address - Phone:570-655-7645
Mailing Address - Fax:570-655-3045
Practice Address - Street 1:457 NORTH MAIN ST.
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSON
Practice Address - State:PA
Practice Address - Zip Code:18640
Practice Address - Country:US
Practice Address - Phone:570-655-7645
Practice Address - Fax:570-655-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030698-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty