Provider Demographics
NPI:1508186545
Name:APPLE DENTAL, PC
Entity Type:Organization
Organization Name:APPLE DENTAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEGGIERI
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:570-546-8888
Mailing Address - Street 1:929 LYCOMING MALL DR
Mailing Address - Street 2:
Mailing Address - City:PENNSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:17756-7837
Mailing Address - Country:US
Mailing Address - Phone:570-546-8888
Mailing Address - Fax:570-546-7053
Practice Address - Street 1:929 LYCOMING MALL DR
Practice Address - Street 2:
Practice Address - City:PENNSDALE
Practice Address - State:PA
Practice Address - Zip Code:17756-7837
Practice Address - Country:US
Practice Address - Phone:570-546-8888
Practice Address - Fax:570-546-7053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027476L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA643550OtherUPIN