Provider Demographics
NPI:1750669503
Name:DENTAL ASSOCIATES OF HERSHEY
Entity type:Organization
Organization Name:DENTAL ASSOCIATES OF HERSHEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-534-2985
Mailing Address - Street 1:1253 COCOA AVE
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1715
Mailing Address - Country:US
Mailing Address - Phone:717-534-2985
Mailing Address - Fax:717-520-1722
Practice Address - Street 1:1253 COCOA AVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1715
Practice Address - Country:US
Practice Address - Phone:717-534-2985
Practice Address - Fax:717-520-1722
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTAL ASSOCIATES OF HERSHEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027898L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty