Provider Demographics
NPI:1780008169
Name:ADVARA DENTAL & DENTURES INC
Entity Type:Organization
Organization Name:ADVARA DENTAL & DENTURES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-564-4600
Mailing Address - Street 1:4640 HIGH POINTE BLVD
Mailing Address - Street 2:SUITE 72
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2463
Mailing Address - Country:US
Mailing Address - Phone:717-564-4600
Mailing Address - Fax:714-564-4601
Practice Address - Street 1:4640 HIGH POINTE BLVD
Practice Address - Street 2:SUITE 72
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2463
Practice Address - Country:US
Practice Address - Phone:717-564-4600
Practice Address - Fax:714-564-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty