# PENNSYLVANIA CENTER FOR DENTAL SLEEP MEDICINE PC

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

## Provider details

- **NPI number:** 1619225810
- **Authorized official:** DR. TERRY M GORDON DDS (PRESIDENT/DENTAL DIRECTOR)
- **Authorized official phone:** (717) 632-1332

## Contact information

- **Practice address:** 1225 CARLISLE ST STE 1B, HANOVER, PA 17331
- **Practice address phone:** (717) 632-1332
- **Practice address fax:** (270) 637-0207
- **Mailing address:** 1225 CARLISLE ST STE 1B, HANOVER, PA 17331-1207
- **Mailing address phone:** (717) 632-1332
- **Mailing address fax:** (270) 637-0207

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 24985 | PA | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 08/17/2012
- **Last updated:** 06/29/2018