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NPI Code Detail

MEDICARE: PROGRESSIVE DENTAL CONCEPTS

MEDICARE: PROGRESSIVE DENTAL CONCEPTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1275114456
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROGRESSIVE DENTAL CONCEPTS
Provider Business Mailing Address
First Line : 173 S 32ND ST
Second Line :
City : CAMP HILL
State : PA
Zip : 17011-5102
Country : US
Telephone Number : 717-599-0456
Fax Number :
Provider Business Practice Location Address
First Line : 1902 BRIDGE ST
Second Line :
City : NEW CUMBERLAND
State : PA
Zip : 17070-1127
Country : US
Telephone Number : 717-774-7700
Fax Number : 717-774-7747
Authorized Official
Title or Position : CENTRALIZED BILLING COORDINATOR
Name : MRS. CASSANDRA L NAILOR
Credential :
Telephone Number : 717-712-3594
Provider Enumeration Date : 04/19/2021
Last Update Date : 04/19/2021

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Directions to “PROGRESSIVE DENTAL CONCEPTS ” Practice Location

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