Provider Demographics
NPI:1336215862
Name:VERBER DENTAL GROUP, PC
Entity type:Organization
Organization Name:VERBER DENTAL GROUP, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREATMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ASCHLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-737-4337
Mailing Address - Street 1:3920 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011
Mailing Address - Country:US
Mailing Address - Phone:717-737-4337
Mailing Address - Fax:717-737-7918
Practice Address - Street 1:3920 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011
Practice Address - Country:US
Practice Address - Phone:717-737-4337
Practice Address - Fax:717-737-7918
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VERBER DENTAL GROUP, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-27
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAD5018462L122300000X
PADS035968261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA003805309OtherHIGHMARK BLUE SHIELD
PA7692170002OtherDMERC REGION A