Provider Demographics
NPI:1750326757
Name:MCCRACKEN FAMILY DENTISTRY, P.C.
Entity Type:Organization
Organization Name:MCCRACKEN FAMILY DENTISTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:WHEELER
Authorized Official - Last Name:MCCRACKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-737-8423
Mailing Address - Street 1:3801 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4328
Mailing Address - Country:US
Mailing Address - Phone:717-737-8423
Mailing Address - Fax:717-737-2351
Practice Address - Street 1:3801 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4328
Practice Address - Country:US
Practice Address - Phone:717-737-8423
Practice Address - Fax:717-737-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-026252-L122300000X
PADS-023495-L122300000X
PADS-026556-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty