Provider Demographics
NPI:1467077495
Name:MECHANICSBURG DENTAL & DENTURES INC
Entity Type:Organization
Organization Name:MECHANICSBURG DENTAL & DENTURES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOSINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-376-6328
Mailing Address - Street 1:PO BOX 1332
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14231-1332
Mailing Address - Country:US
Mailing Address - Phone:717-766-3113
Mailing Address - Fax:
Practice Address - Street 1:5510 CARLISLE PIKE
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2413
Practice Address - Country:US
Practice Address - Phone:717-766-3113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental