MEDICARE: DR. TADMAN GLOSSNER D.D.S.

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
1	122300000X	Dentist	DS030329L	PA

General Provider Information

NPI Number	:	1841464906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TADMAN GLOSSNER D.D.S.

Provider Business Mailing Address
First Line	:	19 S 22ND ST
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-4603
Country	:	US
Telephone Number	:	717-737-7422
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 S 22ND ST
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-4603
Country	:	US
Telephone Number	:	717-737-7422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2008
Last Update Date	:	04/18/2008

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