Provider Demographics
NPI:1407213416
Name:HARTMAN ORAL AND MAXILLOFACIAL SURGERY, PC
Entity Type:Organization
Organization Name:HARTMAN ORAL AND MAXILLOFACIAL SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DMD
Authorized Official - Phone:717-766-7697
Mailing Address - Street 1:101 OLD SCHOOLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5681
Mailing Address - Country:US
Mailing Address - Phone:717-766-7697
Mailing Address - Fax:717-918-5450
Practice Address - Street 1:101 OLD SCHOOLHOUSE LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5681
Practice Address - Country:US
Practice Address - Phone:717-766-7697
Practice Address - Fax:717-918-5450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty