Healthcare Provider Details

I. General information

NPI: 1225554264
Provider Name (Legal Business Name): ANNA M EBERSOL PHDHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 08/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N ARCH ST
LANCASTER PA
17603-2928
US

IV. Provider business mailing address

333 N ARCH ST
LANCASTER PA
17603-2928
US

V. Phone/Fax

Practice location:
  • Phone: 717-299-6371
  • Fax: 717-945-1587
Mailing address:
  • Phone: 717-299-6371
  • Fax: 717-945-1587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: