Provider Demographics
NPI:1962650572
Name:KIESSLING, JOHN HOWARD (DMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HOWARD
Last Name:KIESSLING
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 1:6460 JONESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-2638
Mailing Address - Country:US
Mailing Address - Phone:717-657-3290
Mailing Address - Fax:717-901-6691
Practice Address - Street 1:6460 JONESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2638
Practice Address - Country:US
Practice Address - Phone:717-657-3290
Practice Address - Fax:717-901-6691
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025189L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice