Provider Demographics
NPI:1346546066
Name:YORKSHIRE DENTAL
Entity Type:Organization
Organization Name:YORKSHIRE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOODIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-757-0468
Mailing Address - Street 1:3233 EASTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-3031
Mailing Address - Country:US
Mailing Address - Phone:717-757-0468
Mailing Address - Fax:
Practice Address - Street 1:3233 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3031
Practice Address - Country:US
Practice Address - Phone:717-757-0468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023051L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty