Provider Demographics
NPI:1881868602
Name:DETAR, APRIL ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:ANN
Last Name:DETAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2182 SANDY DR STE 102
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2282
Mailing Address - Country:US
Mailing Address - Phone:814-234-4444
Mailing Address - Fax:814-954-5652
Practice Address - Street 1:2182 SANDY DR STE 102
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803
Practice Address - Country:US
Practice Address - Phone:814-234-4444
Practice Address - Fax:814-954-5652
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2018-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031506L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice