Healthcare Provider Details

I. General information

NPI: 1477942993
Provider Name (Legal Business Name): SAMUELS DENTAL ARTS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 BIGLERVILLE RD
GETTYSBURG PA
17325-8031
US

IV. Provider business mailing address

1650 BIGLERVILLE RD
GETTYSBURG PA
17325-8031
US

V. Phone/Fax

Practice location:
  • Phone: 717-334-0555
  • Fax:
Mailing address:
  • Phone: 717-334-0555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS023791-L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDS035281
License Number StatePA

VIII. Authorized Official

Name: PETER J SAMUELS
Title or Position: PRESIDENT/OWNER
Credential: DDS
Phone: 717-334-0555