Provider Demographics
NPI:1316088222
Name:HECHT ORAL AND MAXILLOFACIAL SURGERY
Entity type:Organization
Organization Name:HECHT ORAL AND MAXILLOFACIAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCHENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-530-1120
Mailing Address - Street 1:127 WALNUT BOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:SHIPPENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17257-8131
Mailing Address - Country:US
Mailing Address - Phone:717-530-1120
Mailing Address - Fax:717-530-5185
Practice Address - Street 1:127 WALNUT BOTTOM RD
Practice Address - Street 2:
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-8131
Practice Address - Country:US
Practice Address - Phone:717-530-1120
Practice Address - Fax:717-530-5184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
02534800OtherKEYSTONE HEALTH PLAN CENT
332794OtherHEALTH AMERICA
116673OtherUNITED CONCORDIA
116673OtherHIGHMARK BLUE SHIELD
02534800OtherCAPITAL BLUE CROSS
PA0014332960003Medicaid
548740OtherAETNA US HEALTH CARE