Healthcare Provider Details

I. General information

NPI: 1306115548
Provider Name (Legal Business Name): HERSHEY DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2011
Last Update Date: 09/08/2024
Certification Date: 09/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 E CHOCOLATE AVE # 101
HERSHEY PA
17033-1325
US

IV. Provider business mailing address

174 WILLOW CREEK LN
HUMMELSTOWN PA
17036-6503
US

V. Phone/Fax

Practice location:
  • Phone: 717-312-7030
  • Fax: 717-298-1752
Mailing address:
  • Phone: 717-312-7030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberDS 038286
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. BHARGAV PATEL
Title or Position: PRESIDENT
Credential: DMD
Phone: 717-312-7030