# LITITZ ORAL SURGERY

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

## Provider details

- **NPI number:** 1861585861
- **Authorized official:** SIOBHAN MCMICHAEL (PRACTICE ADMIN)
- **Authorized official phone:** (717) 627-2299

## Contact information

- **Practice address:** 1575 HIGHLANDS DR STE 106, LITITZ, PA 17543-7507
- **Practice address phone:** (717) 627-2299
- **Practice address fax:** (717) 627-4330
- **Mailing address:** 1575 HIGHLANDS DR STE 106, LITITZ, PA 17543-7507
- **Mailing address phone:** (717) 627-2299
- **Mailing address fax:** (717) 627-4330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS028494L | PA | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | DS028494L | PA | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 09/27/2023