Organization
LITITZ ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIOBHAN MCMICHAEL (PRACTICE ADMIN)
(717) 627-2299
Entity
Organization
Contact information
Practice address
1575 HIGHLANDS DR STE 106, LITITZ, PA 17543-7507
(717) 627-2299
(717) 627-4330
Mailing address
1575 HIGHLANDS DR STE 106, LITITZ, PA 17543-7507
(717) 627-2299
(717) 627-4330
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS028494L
PA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DS028494L
PA
Other
Enumeration date
10/02/2006
Last updated
09/27/2023
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