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General NPI Number Information
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NPI Number | 1154431245
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Entity Type | Organization
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Legal Business Name | CLEVELAND L. NULL, DDS, PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 09/27/2010
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Provider Practice Location Address
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Address Line | 353 YORK ST
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City | GETTYSBURG
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State | PA
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Zip | 17325-1931
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Country | US
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Telephone | 717-334-8193
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Fax | 717-334-8432
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Provider Business Mailing Address
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Address Line | 353 YORK ST
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City | GETTYSBURG
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State | PA
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Zip | 17325-1931
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Country | US
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Telephone | 717-334-8193
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Fax | 717-334-8432
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLEVELAND L. NULL
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Credential | DDS
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Telephone | 717-334-8193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS-020984L
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License Number State | PA
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