Provider Demographics
NPI:1710088901
Name:LANCASTER, DWIGHT CHARLES (DMD)
Entity Type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:CHARLES
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 LINCOLN HWY E
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2611
Mailing Address - Country:US
Mailing Address - Phone:717-299-7322
Mailing Address - Fax:717-299-7366
Practice Address - Street 1:1709 LINCOLN HWY E
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2611
Practice Address - Country:US
Practice Address - Phone:717-299-7322
Practice Address - Fax:717-299-7366
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-025004-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice