Healthcare Provider Details

I. General information

NPI: 1275492720
Provider Name (Legal Business Name): KEYSTONE ORAL SURGERY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 LINCOLN WAY E
CHAMBERSBURG PA
17201-2819
US

IV. Provider business mailing address

30 BALDWIN BLVD STE 95
SHAMOKIN DAM PA
17876-9520
US

V. Phone/Fax

Practice location:
  • Phone: 717-983-0627
  • Fax: 717-983-2221
Mailing address:
  • Phone: 610-570-8321
  • Fax: 570-256-1772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAREN L FITZCHARLES
Title or Position: CREDENTIALING
Credential:
Phone: 570-884-8321