Provider Demographics
NPI:1902220544
Name:STEVEN A. WITKOWSKI, D.D.S.
Entity Type:Organization
Organization Name:STEVEN A. WITKOWSKI, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WITKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-533-7860
Mailing Address - Street 1:475 W GOVERNOR RD
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2217
Mailing Address - Country:US
Mailing Address - Phone:717-533-7860
Mailing Address - Fax:717-533-4483
Practice Address - Street 1:475 W GOVERNOR RD
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2217
Practice Address - Country:US
Practice Address - Phone:717-533-7860
Practice Address - Fax:717-533-4483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS07073L251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare