Organization
COVENANT FAMILY DENTAL LLC
Active
Other names
Greencastle Family Dental, Grencastle Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ANVARALI MOHAMMADH DMD (OWNER)
(717) 762-1515
Entity
Organization
Contact information
Practice address
50 EASTERN AVE STE 108, GREENCASTLE, PA 17225-1100
(717) 762-1515
Mailing address
750 S POTOMAC ST, WAYNESBORO, PA 17268-2198
(717) 762-1515
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1038734820001
—
PA
Enumeration date
08/23/2021
Last updated
09/27/2021
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