# FREDERICKSBURG DENTAL CENTER, LLC

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

## Provider details

- **NPI number:** 1376645507
- **Authorized official:** DR. ANDREW THOMAS STEWART DMD (OWNER)
- **Authorized official phone:** (717) 865-3457

## Contact information

- **Practice address:** 120 SOUTH TAN STREET, FREDERICKSBURG, PA 17026
- **Practice address phone:** (717) 865-3457
- **Practice address fax:** (717) 865-2101
- **Mailing address:** PO BOX 69, 120 SOUTH TAN STREET, FREDERICKSBURG, PA 17026
- **Mailing address phone:** (717) 865-3457
- **Mailing address fax:** (717) 865-2101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 25124L | PA | Yes |
| 122300000X | Dentist | 28749L | PA | — |

## Other

- **Enumeration date:** 09/01/2006
- **Last updated:** 01/02/2014