| Cornwall Family Dentistry, Llc | |
|
850 Norman Dr Lebanon PA 17042-7444 | |
| (717) 272-3079 | |
| (717) 228-1404 |
| Full Name | Cornwall Family Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 850 Norman Dr, Lebanon, Pennsylvania |
| Authorized Official Name and Position | Richard Koslowski (OWNER) |
| Authorized Official Contact | 7172723079 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornwall Family Dentistry, Llc 850 Norman Dr Lebanon PA 17042-7444 Ph: (717) 272-3079 | Cornwall Family Dentistry, Llc 850 Norman Dr Lebanon PA 17042-7444 Ph: (717) 272-3079 |
| NPI Number | 1962868968 |
|---|---|
| Provider Enumeration Date | 01/06/2016 |
| Last Update Date | 01/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962868968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS-027778-L (Pennsylvania) | Primary |
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