Provider Demographics
NPI:1376146399
Name:ABOVE & BEYOND FAMILY DENTISTRY, LLC
Entity Type:Organization
Organization Name:ABOVE & BEYOND FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARIK
Authorized Official - Middle Name:W
Authorized Official - Last Name:JBARAH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-820-7113
Mailing Address - Street 1:138 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2500
Mailing Address - Country:US
Mailing Address - Phone:717-632-8571
Mailing Address - Fax:717-632-6466
Practice Address - Street 1:211 KENNEDY CT STE 2
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-5205
Practice Address - Country:US
Practice Address - Phone:717-632-4337
Practice Address - Fax:717-632-6832
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABOVE & BEYOND FAMILY DENTISTRY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty