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General NPI Number Information
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NPI Number | 1538244595
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Entity Type | Organization
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Legal Business Name | QUEENSGATE DENTAL
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 2081 SPRINGWOOD RD
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City | YORK
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State | PA
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Zip | 17403
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Country | US
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Telephone | 717-843-8011
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Fax | 717-843-4414
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Provider Business Mailing Address
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Address Line | 2087 SPRINGWOOD RD
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City | YORK
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State | PA
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Zip | 17403-4827
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Country | US
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Telephone | 717-843-8011
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Fax | 717-843-4414
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Authorized Official
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Title or Position | OWNER PRESIDENT DENTIST
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Name | DR. WILLIAM H CLOYD
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Credential | DMD
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Telephone | 717-843-8011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS024963L
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License Number State | PA
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