Organization
COLUMBIA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA BAZZLE (OWNER)
(717) 586-3201
Entity
Organization
Contact information
Practice address
846 LANCASTER AVE, COLUMBIA, PA 17512-2206
(717) 586-3201
Mailing address
2685 ROSEBAY DR, YORK, PA 17408-4069
(717) 586-3201
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8669500005
—
PA
Enumeration date
08/19/2020
Last updated
08/19/2020
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