| Locust Lane Dental Group | |
|
5525 Locust Lane Harrisburg PA 17109 | |
| (717) 652-6352 | |
| (717) 541-0771 |
| Full Name | Locust Lane Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 5525 Locust Lane, Harrisburg, Pennsylvania |
| Authorized Official Name and Position | Glenn C Seitz (DENTIST) |
| Authorized Official Contact | 7176526352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Locust Lane Dental Group 5525 Locust Lane Harrisburg PA 17109 Ph: (717) 652-6352 | Locust Lane Dental Group 5525 Locust Lane Harrisburg PA 17109 Ph: (717) 652-6352 |
| NPI Number | 1093891848 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 07/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093891848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS030972L (Pennsylvania) | Primary |
| 1223G0001X | Dentist - General Practice | DS030972L (Pennsylvania) | Secondary |
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