Organization
LEBER & BANDUCCI PLASTIC SURGERY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN DALE DEITER MD (SECRETARY/TREASURER)
(717) 233-4691
Entity
Organization
Contact information
Practice address
2807 N FRONT ST, HARRISBURG, PA 17110-1222
(717) 233-4691
(717) 233-8836
Mailing address
2807 N FRONT ST, HARRISBURG, PA 17110-1222
(717) 233-4691
(717) 233-8836
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD-012624-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007401670002
—
PA
Enumeration date
07/06/2006
Last updated
10/12/2010
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