Jack Britten, DMD
Individual provider Active NPI Dentist · Brockway, PA
NPI 1326314725 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1326314725
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS016347L (PA)
- Practice address
- 2200 Main St
Brockway, PA 15824 - Phone
- (814) 265-0820
- NPI assigned
- Mar 29, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS016347L | PA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS016347L | PA | Yes |
Addresses
Primary practice location
2200 Main St
Brockway, PA 15824
Mailing address
2200 Main St
Brockway, PA 15824
Phone (814) 265-0820
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DS016347L | Other | PA | PENNSYLVANIA STATE LICENSE NUMBER |
Other providers in Brockway, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.