Organization
PENNSYLVANIA DENTAL PARTNERS, LLC
Active
Parent organization
BLACKFORD DENTAL MANAGEMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLACKFORD DENTAL MANAGEMENT
Authorized official
DR. THOMAS P. DUDAS JR. DMD (OWNER)
(717) 519-0100
Entity
Organization
Contact information
Practice address
355 W MAIN ST, LEOLA, PA 17540-2107
(717) 656-3051
(717) 656-6205
Mailing address
120 N POINTE BLVD, STE.300, LANCASTER, PA 17601-4100
(717) 519-0100
(717) 569-8063
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS026808L
PA
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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