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General NPI Number Information
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NPI Number | 1154539427
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Entity Type | Individual
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Provider Name | RICHARD ALLEN HARTLAND II DMD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | HC 6 BOX 6924
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City | HAWLEY
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State | PA
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Zip | 18428-9002
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Country | US
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Telephone | 570-226-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 305 SCHOOL SIDE DR
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City | THROOP
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State | PA
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Zip | 18512-1456
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Country | US
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Telephone | 570-383-0784
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS031081L
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License Number State | PA
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