Provider Demographics
NPI:1295815306
Name:WESLEY W. SABOCHECK, DMD
Entity type:Organization
Organization Name:WESLEY W. SABOCHECK, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SABOCHECK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-671-5984
Mailing Address - Street 1:4341 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-9531
Mailing Address - Country:US
Mailing Address - Phone:717-671-5984
Mailing Address - Fax:
Practice Address - Street 1:4341 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-9531
Practice Address - Country:US
Practice Address - Phone:717-671-5984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021636L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29576Medicare UPIN
PA0015443750001Medicare ID - Type Unspecified
PA145204Medicare UPIN