Provider Demographics
NPI:1851728232
Name:MERCERSBURG FAMILY DENTISTRY
Entity Type:Organization
Organization Name:MERCERSBURG FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-328-5700
Mailing Address - Street 1:200 LOUDON ROAD
Mailing Address - Street 2:
Mailing Address - City:MERCERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17236
Mailing Address - Country:US
Mailing Address - Phone:717-328-5700
Mailing Address - Fax:717-328-4310
Practice Address - Street 1:200 LOUDON ROAD
Practice Address - Street 2:
Practice Address - City:MERCERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17236
Practice Address - Country:US
Practice Address - Phone:717-328-5700
Practice Address - Fax:717-328-4310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029583L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty