# SMILES BY SHANNON DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306409263
- **Authorized official:** JENNIFER SHANNON DMD (OWNDER)
- **Authorized official phone:** (717) 956-6000

## Contact information

- **Practice address:** 4400 DEER PATH RD STE 101, HARRISBURG, PA 17110-3908
- **Practice address phone:** (717) 956-6000
- **Mailing address:** 4283 STELLATA CT, HARRISBURG, PA 17112-2763
- **Mailing address phone:** (717) 364-5986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/17/2019
- **Last updated:** 04/17/2019