Provider Demographics
NPI:1396162731
Name:HERSHEY DENTAL ASSOCIATES LLC
Entity type:Organization
Organization Name:HERSHEY DENTAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:GEOFFREY
Authorized Official - Last Name:BUEHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-220-1792
Mailing Address - Street 1:273 HERSHEY RD
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-9246
Mailing Address - Country:US
Mailing Address - Phone:717-220-1792
Mailing Address - Fax:717-220-1796
Practice Address - Street 1:273 HERSHEY RD
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-9246
Practice Address - Country:US
Practice Address - Phone:717-220-1792
Practice Address - Fax:717-220-1796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0365961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty