Provider Demographics
NPI:1720079122
Name:DENTE, CARLA J (MD)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:J
Last Name:DENTE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:108 LOWTHER ST
Mailing Address - Street 2:INTERNISTS OF CENTRAL PA LTD
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-2045
Mailing Address - Country:US
Mailing Address - Phone:717-774-1366
Mailing Address - Fax:717-774-4232
Practice Address - Street 1:108 LOWTHER ST
Practice Address - Street 2:INTERNISTS OF CENTRAL PA LTD
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-2045
Practice Address - Country:US
Practice Address - Phone:717-774-1366
Practice Address - Fax:717-774-4232
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2011-06-28
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Provider Licenses
StateLicense IDTaxonomies
PAMD068887L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017454440001Medicaid
PA0017454440001Medicaid
G91548Medicare UPIN