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General NPI Number Information
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NPI Number | 1578733895
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Entity Type | Organization
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Legal Business Name | CANTWELL DENTAL GROUP LTD
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 2207 OREGON PIKE STE 101
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City | LANCASTER
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State | PA
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Zip | 17601-4669
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Country | US
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Telephone | 717-509-7111
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Fax | 717-509-8527
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Provider Business Mailing Address
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Address Line | 2207 OREGON PIKE STE 101
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City | LANCASTER
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State | PA
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Zip | 17601-4669
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Country | US
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Telephone | 717-509-7111
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Fax | 717-509-8527
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Authorized Official
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Title or Position | FINANCIAL COORDINATOR
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Name | MRS. NICOLE M MYER
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Credential |
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Telephone | 717-509-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DSO31346L
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License Number State | PA
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