Provider Demographics
NPI:1841825015
Name:ABOVE & BEYOND FAMILY DENTISTRY, LLC
Entity type:Organization
Organization Name:ABOVE & BEYOND FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING/PERSONAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-476-3239
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:YORK NEW SALEM
Mailing Address - State:PA
Mailing Address - Zip Code:17371-0307
Mailing Address - Country:US
Mailing Address - Phone:717-792-0484
Mailing Address - Fax:717-792-9723
Practice Address - Street 1:286 N MAIN ST
Practice Address - Street 2:
Practice Address - City:YORK NEW SALEM
Practice Address - State:PA
Practice Address - Zip Code:17371-2009
Practice Address - Country:US
Practice Address - Phone:717-792-0484
Practice Address - Fax:717-792-9723
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABOVE & BEYOND FAMILY DENTISTRY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032509120002Medicaid
PA1036228850001Medicaid