=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821634577
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SWEET DREAMS GETTYSBURG LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2019
-----------------------------------------------------
Last Update Date | 11/18/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2018 YORK RD
-----------------------------------------------------
City | GETTYSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17325-8207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-339-0033
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2018 YORK RD
-----------------------------------------------------
City | GETTYSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17325-8207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-339-0033
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. RITA A TEMPEL
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 717-339-0033
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------