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NPI 1821554221

NPI 1821554221 : ANDREW D. PEDERSEN, DDS, MS, PLLC : YORK, PA

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General NPI Number Information
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    NPI Number           |    1821554221
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    Entity Type          |    Organization 
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    Legal Business Name  |    ANDREW D. PEDERSEN, DDS, MS, PLLC 
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Dates
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    Enumeration Date     |    02/11/2019
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    Last Update Date     |    02/11/2019
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Provider Practice Location Address
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    Address Line         |    1589 CARLISLE RD 
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    City                 |    YORK
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    State                |    PA
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    Zip                  |    17408-4528
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    Country              |    US
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    Telephone            |    717-764-3854
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1589 CARLISLE RD 
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    City                 |    YORK
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    State                |    PA
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    Zip                  |    17408-4528
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    Country              |    US
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    Telephone            |    717-764-3854
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    Fax                  |    
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Authorized Official
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    Title or Position    |    BUSINESS COORDINATOR
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    Name                 |     VIRGINIA  ARSLAIN 
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    Credential           |    
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    Telephone            |    717-764-3854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    
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    License Number State |    
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