Provider Demographics
NPI:1770788507
Name:PANDENTAL, LTD
Entity type:Organization
Organization Name:PANDENTAL, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-366-1014
Mailing Address - Street 1:1439 CENTRE TPKE
Mailing Address - Street 2:ROUTE 61
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-9066
Mailing Address - Country:US
Mailing Address - Phone:570-366-1014
Mailing Address - Fax:570-366-3894
Practice Address - Street 1:1901 BERNVILLE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-1113
Practice Address - Country:US
Practice Address - Phone:610-621-2099
Practice Address - Fax:610-621-5666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty