Provider Demographics
NPI:1225227192
Name:DENTAL ART IMAGES LLC
Entity Type:Organization
Organization Name:DENTAL ART IMAGES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-272-8500
Mailing Address - Street 1:221 W PENN AVE
Mailing Address - Street 2:SUITE 213
Mailing Address - City:CLEONA
Mailing Address - State:PA
Mailing Address - Zip Code:17042
Mailing Address - Country:US
Mailing Address - Phone:717-272-8500
Mailing Address - Fax:717-272-6101
Practice Address - Street 1:221 W PENN AVE
Practice Address - Street 2:SUITE 213
Practice Address - City:CLEONA
Practice Address - State:PA
Practice Address - Zip Code:17042
Practice Address - Country:US
Practice Address - Phone:717-272-8500
Practice Address - Fax:717-272-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035405122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty