Provider Demographics
NPI:1770043226
Name:DENTISTRY ON THE SQUARE
Entity Type:Organization
Organization Name:DENTISTRY ON THE SQUARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARI
Authorized Official - Middle Name:LINSTROM
Authorized Official - Last Name:STUNTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-393-6888
Mailing Address - Street 1:416 WILLETA CT
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-8249
Mailing Address - Country:US
Mailing Address - Phone:240-393-6888
Mailing Address - Fax:
Practice Address - Street 1:25 CENTER SQ
Practice Address - Street 2:
Practice Address - City:NEW OXFORD
Practice Address - State:PA
Practice Address - Zip Code:17350-1401
Practice Address - Country:US
Practice Address - Phone:717-624-2114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty