Provider Demographics
NPI:1609895887
Name:SCOTT A. CREISHER D.D.S.,P.C.
Entity Type:Organization
Organization Name:SCOTT A. CREISHER D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CREISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-394-2641
Mailing Address - Street 1:1059 COLUMBIA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3130
Mailing Address - Country:US
Mailing Address - Phone:717-394-2641
Mailing Address - Fax:717-394-3157
Practice Address - Street 1:1059 COLUMBIA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3130
Practice Address - Country:US
Practice Address - Phone:717-394-2641
Practice Address - Fax:717-394-3157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-029455-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty