Provider Demographics
NPI:1821554221
Name:ANDREW D. PEDERSEN, DDS, MS, PLLC
Entity Type:Organization
Organization Name:ANDREW D. PEDERSEN, DDS, MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-764-3854
Mailing Address - Street 1:1589 CARLISLE RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-4528
Mailing Address - Country:US
Mailing Address - Phone:717-764-3854
Mailing Address - Fax:
Practice Address - Street 1:1589 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-4528
Practice Address - Country:US
Practice Address - Phone:717-764-3854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty