Healthcare Provider Details

I. General information

NPI: 1811520976
Provider Name (Legal Business Name): PROGRESSIVE DENTAL CONCEPTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 POPLAR CHURCH RD STE 404
CAMP HILL PA
17011-2250
US

IV. Provider business mailing address

173 S 32ND ST
CAMP HILL PA
17011-5102
US

V. Phone/Fax

Practice location:
  • Phone: 717-761-2453
  • Fax:
Mailing address:
  • Phone: 717-599-0456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES FOER
Title or Position: COO
Credential:
Phone: 717-580-3603