| Paxtang Family Dentistry Inc | |
|
3404 Derry St Suite 1 Harrisburg PA 17111-1834 | |
| (717) 561-1209 | |
| (717) 561-4033 |
| Full Name | Paxtang Family Dentistry Inc |
|---|---|
| Speciality | Dentist |
| Location | 3404 Derry St, Harrisburg, Pennsylvania |
| Authorized Official Name and Position | Jill Rachael Carre (OWNER) |
| Authorized Official Contact | 7175611209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paxtang Family Dentistry Inc 3404 Derry St Suite 1 Harrisburg PA 17111-1834 Ph: (717) 561-1209 | Paxtang Family Dentistry Inc 3404 Derry St Suite 1 Harrisburg PA 17111-1834 Ph: (717) 561-1209 |
| NPI Number | 1639446057 |
|---|---|
| Provider Enumeration Date | 11/30/2011 |
| Last Update Date | 11/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639446057 | NPI | - | NPPES |
| 1024184100001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS035741 (Pennsylvania) | Primary |
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