Provider Demographics
NPI:1710044300
Name:ISEMAN, CYNTHIA A (DMD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:ISEMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRANT STREET
Mailing Address - Street 2:PO BOX 338
Mailing Address - City:SALISBURY
Mailing Address - State:PA
Mailing Address - Zip Code:15558
Mailing Address - Country:US
Mailing Address - Phone:814-662-2771
Mailing Address - Fax:814-662-2771
Practice Address - Street 1:100 GRANT STREET
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:PA
Practice Address - Zip Code:15558
Practice Address - Country:US
Practice Address - Phone:814-662-2771
Practice Address - Fax:814-662-2771
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030306L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
9472000000030306OtherDELTA DENTAL
PA0017775550005OtherMEDICAL ASSISTANCE
PA142397OtherUNISON MED PLUS
0007194469OtherAETNA
PA0008936OtherUPMC
001427229OtherHIGH MARK BS & UNITED CON