| Fredericksburg Dental Center, Llc | |
|
120 South Tan Street Fredericksburg PA 17026 | |
| (717) 865-3457 | |
| (717) 865-2101 |
| Full Name | Fredericksburg Dental Center, Llc |
|---|---|
| Speciality | Dentist |
| Location | 120 South Tan Street, Fredericksburg, Pennsylvania |
| Authorized Official Name and Position | Andrew Thomas Stewart (OWNER) |
| Authorized Official Contact | 7178653457 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fredericksburg Dental Center, Llc Po Box 69 120 South Tan Street Fredericksburg PA 17026 Ph: (717) 865-3457 | Fredericksburg Dental Center, Llc 120 South Tan Street Fredericksburg PA 17026 Ph: (717) 865-3457 |
| NPI Number | 1376645507 |
|---|---|
| Provider Enumeration Date | 09/01/2006 |
| Last Update Date | 01/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376645507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 25124L (Pennsylvania) | Primary |
| 122300000X | Dentist | 28749L (Pennsylvania) | Secondary |