Provider Demographics
NPI:1407999063
Name:HARTMAN, MICHAEL J (DMD, MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MARKET PLAZA WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5679
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0373511223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery