Organization
PARKSIDE DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANA LYNN MATHIAS DDS (OWNER)
(717) 367-2423
Entity
Organization
Contact information
Practice address
420 E PARK ST, ELIZABETHTOWN, PA 17022-2267
(717) 367-2423
(717) 367-9664
Mailing address
420 E PARK ST, ELIZABETHTOWN, PA 17022-2267
(717) 367-2423
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018490460002
—
PA
Enumeration date
04/27/2020
Last updated
04/27/2020
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