Provider Demographics
NPI:1417663238
Name:YORKTOWN DENTAL CARE PLLC
Entity Type:Organization
Organization Name:YORKTOWN DENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-882-3448
Mailing Address - Street 1:2851 EASTERN BLVD.
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402
Mailing Address - Country:US
Mailing Address - Phone:717-757-9614
Mailing Address - Fax:717-755-4577
Practice Address - Street 1:2851 EASTERN BLVD.
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402
Practice Address - Country:US
Practice Address - Phone:717-757-9614
Practice Address - Fax:717-755-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center