Healthcare Provider Details

I. General information

NPI: 1861913949
Provider Name (Legal Business Name): LANCASTER ORAL SURGERY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 06/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1834 OREGON PIKE STE 21
LANCASTER PA
17601-6463
US

IV. Provider business mailing address

1834 OREGON PIKE STE 21
LANCASTER PA
17601-6463
US

V. Phone/Fax

Practice location:
  • Phone: 717-740-2373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RICHARD H. ALBRIGHT JR.
Title or Position: PRESIDENT
Credential:
Phone: 717-569-6421