Provider Demographics
NPI:1790466894
Name:GUTHRIE DENTAL, LLC
Entity Type:Organization
Organization Name:GUTHRIE DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-531-4396
Mailing Address - Street 1:108 DOE RUN RD
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-8502
Mailing Address - Country:US
Mailing Address - Phone:717-879-9700
Mailing Address - Fax:
Practice Address - Street 1:108 DOE RUN RD
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-8502
Practice Address - Country:US
Practice Address - Phone:717-879-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental