MEDICARE: DR. CLIFFORD DEAN SENSENIG DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS027088L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	111101	OTHER	UNISON
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	275291	OTHER	GATEWAY HEALTH PLUS

General Provider Information

NPI Number	:	1093870891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLIFFORD DEAN SENSENIG DMD

Provider Business Mailing Address
First Line	:	1418 BRUNNERVILLE ROAD
Second Line	:
City	:	LITITZ
State	:	PA
Zip	:	17543-9726
Country	:	US
Telephone Number	:	717-626-7101
Fax Number	:

Provider Business Practice Location Address
First Line	:	1829 MARKET STREET
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17103-2524
Country	:	US
Telephone Number	:	717-236-0300
Fax Number	:	717-236-4611

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	07/08/2007

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