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General NPI Number Information
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NPI Number | 1174626220
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Entity Type | Organization
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Legal Business Name | SMOKETOWN FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 2433 C OLD PHILADELPHIA PIKE
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City | SMOKETOWN
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State | PA
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Zip | 17576
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Country | US
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Telephone | 717-291-6035
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Fax | 717-291-5538
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Provider Business Mailing Address
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Address Line | 2433 C OLD PHILADELPHIA PIKE PO BOX 369
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City | SMOKETOWN
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State | PA
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Zip | 17576
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Country | US
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Telephone | 717-291-6035
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Fax | 717-291-5538
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES E LENAHAN
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Credential | DDS
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Telephone | 717-291-6035
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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 | DS027477L
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License Number State | PA
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