Healthcare Provider Details

I. General information

NPI: 1275550907
Provider Name (Legal Business Name): JEFFREY EBY, DMD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N 7TH ST SUITE 400
AKRON PA
17501-1361
US

IV. Provider business mailing address

240 N 7TH ST SUITE 400
AKRON PA
17501-1361
US

V. Phone/Fax

Practice location:
  • Phone: 717-859-4170
  • Fax: 717-859-4174
Mailing address:
  • Phone: 717-859-4170
  • Fax: 717-859-4174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS030794L
License Number StatePA

VIII. Authorized Official

Name: DR. JEFFREY R EBY
Title or Position: OWNER
Credential: DMD
Phone: 717-859-4170