# KEN FOSTER, DMD LLC

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

## Provider details

- **NPI number:** 1710267869
- **Authorized official:** DR. KENNETH ROBERT FOSTER JR. DMD (DENTIST/OWNER)
- **Authorized official phone:** (570) 678-3384

## Contact information

- **Practice address:** 683 S. MOUNTAIN BLVD SUITE\#4, MOUNTAIN TOP, PA 18707-9603
- **Practice address phone:** (570) 678-3383
- **Mailing address:** 683 S. MOUNTAIN BLVD SUITE\#4, MOUNTAIN TOP, PA 18707-9603
- **Mailing address phone:** (570) 678-3383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS036877 | PA | Yes |

## Other

- **Enumeration date:** 08/22/2011
- **Last updated:** 08/22/2011