Provider Demographics
NPI:1891311494
Name:OWARE, OFORI (DMD)
Entity Type:Individual
Prefix:DR
First Name:OFORI
Middle Name:
Last Name:OWARE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 MAYER PL
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-3988
Mailing Address - Country:US
Mailing Address - Phone:856-506-2951
Mailing Address - Fax:
Practice Address - Street 1:815 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1642
Practice Address - Country:US
Practice Address - Phone:717-306-9412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042744122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist