# PENNSYLVANIA DENTAL PARTNERS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BLACKFORD DENTAL MANAGEMENT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891032629
- **Legal business name:** BLACKFORD DENTAL MANAGEMENT
- **Authorized official:** DR. THOMAS P. DUDAS JR. DMD (OWNER)
- **Authorized official phone:** (717) 519-0100

## Contact information

- **Practice address:** 355 W MAIN ST, LEOLA, PA 17540-2107
- **Practice address phone:** (717) 656-3051
- **Practice address fax:** (717) 656-6205
- **Mailing address:** 120 N POINTE BLVD, STE.300, LANCASTER, PA 17601-4100
- **Mailing address phone:** (717) 519-0100
- **Mailing address fax:** (717) 569-8063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS026808L | PA | Yes |

## Other

- **Enumeration date:** 01/14/2013
- **Last updated:** 01/14/2013