Provider Demographics
NPI:1326660861
Name:HARVEST DENTAL LLC
Entity Type:Organization
Organization Name:HARVEST DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SIEGRIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-466-6655
Mailing Address - Street 1:250 N READING RD
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1649
Mailing Address - Country:US
Mailing Address - Phone:717-466-6655
Mailing Address - Fax:717-466-6650
Practice Address - Street 1:250 N READING RD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1649
Practice Address - Country:US
Practice Address - Phone:717-466-6655
Practice Address - Fax:717-466-6650
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARVEST DENTAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty