Healthcare Provider Details

I. General information

NPI: 1114725439
Provider Name (Legal Business Name): ESTHER GARCIA KELLEHER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 ELM AVE
LANCASTER PA
17603-4632
US

IV. Provider business mailing address

841 3RD ST
LANCASTER PA
17603-5020
US

V. Phone/Fax

Practice location:
  • Phone: 717-744-0477
  • Fax:
Mailing address:
  • Phone: 267-252-4482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH073369
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: