# APPLE DENTAL ASSOCIATE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lycoming Dental Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316616493
- **Authorized official:** DR. NAGA T GUNTUPALLI DMD (OWNER/DENTIST)
- **Authorized official phone:** (570) 546-8888

## Contact information

- **Practice address:** 929 LYCOMING MALL DRIVE, PENNSDALE, PA 17756
- **Practice address phone:** (570) 546-8888
- **Practice address fax:** (570) 546-7053
- **Mailing address:** 929 LYCOMING MALL DR., PENNSDALE, PA 17756
- **Mailing address phone:** (570) 546-8888
- **Mailing address fax:** (570) 546-7053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2021
- **Last updated:** 09/10/2021