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General NPI Number Information
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NPI Number | 1083128003
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Entity Type | Organization
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Legal Business Name | RICHARD D. KNOWLTON, DMD
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 11/29/2017
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Provider Practice Location Address
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Address Line | 102 W HIGH ST
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City | ELIZABETHTOWN
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State | PA
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Zip | 17022-2019
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Country | US
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Telephone | 717-367-1560
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Fax | 717-367-8856
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Provider Business Mailing Address
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Address Line | 102 WEST HIGH STREET
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City | ELIZABETHTOWN
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State | PA
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Zip | 17022-2091
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Country | US
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Telephone | 717-367-1560
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Fax | 717-367-8856
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD D KNOWLTON JR.
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Credential | DMD, MAGD, FICO
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Telephone | 717-367-1560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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