Provider Demographics
NPI:1932253564
Name:WHEATLYN DENTAL PRACTICE, LLP
Entity Type:Organization
Organization Name:WHEATLYN DENTAL PRACTICE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:HARHAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-266-3601
Mailing Address - Street 1:222 ROSEDALE DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:17345-1023
Mailing Address - Country:US
Mailing Address - Phone:717-266-3601
Mailing Address - Fax:717-266-2884
Practice Address - Street 1:222 ROSEDALE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:PA
Practice Address - Zip Code:17345-1023
Practice Address - Country:US
Practice Address - Phone:717-266-3601
Practice Address - Fax:717-266-2884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021571L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty