Provider Demographics
NPI:1225198385
Name:DENTAL ASSOCIATES OF LANCASTER, INC
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES OF LANCASTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:B
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-654-3660
Mailing Address - Street 1:115 W FAIR AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1804
Mailing Address - Country:US
Mailing Address - Phone:740-654-3660
Mailing Address - Fax:740-654-3643
Practice Address - Street 1:115 W FAIR AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1804
Practice Address - Country:US
Practice Address - Phone:740-654-3660
Practice Address - Fax:740-654-3643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH141021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty