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Organization

HAVEN ORTHODONTICS, PC

Active
Other names
Pottsville Orthodontics, PC (fictitious name)
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JASON MICHAEL HARTMAN D.M.D., M.S. (PRESIDENT/ORTHODONTIST)
(570) 385-1344
Entity
Organization

Contact information

Practice address
103 E MAIN ST, SCHUYLKILL HAVEN, PA 17972-1240
(570) 385-1344
Mailing address
103 E MAIN ST, SCHUYLKILL HAVEN, PA 17972-1240
(570) 385-1344

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS038055
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023923970001
PA
Enumeration date
07/17/2012
Last updated
07/30/2012
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