David A Eichenlaub & Gary R Bodmer, Partners
Clinic/Center, Dental in Lewistown, PA. Organization (NPI-2).
NPI number1093220105
StatusActive
Last updated in NPPESJun 16, 2018
Details
- NPI
- 1093220105
- Entity type
- Organization (NPI-2)
- Legal business name
- David A Eichenlaub & Gary R Bodmer, Partners
- Organization subpart
- No
- Enumeration date
- Dec 12, 2017
- Last updated
- Jun 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | DS017307L | PA | Yes |
| 261QD0000X | Clinic/Center, Dental | DS021903L | PA |
Practice location
744 Valley StLewistown, PA 17044-1425
Phone 717-248-4896
Mailing address
744 Valley StLewistown, PA 17044-1425
Phone 717-248-4896
Authorized official
Lavonne Kay Kirkland
Office Manager
7172484896
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