Provider Demographics
NPI:1174733703
Name:ASUNCION DENTAL LLC
Entity type:Organization
Organization Name:ASUNCION DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:PURA
Authorized Official - Last Name:ASUNCION
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-653-8558
Mailing Address - Street 1:422 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MOUNT JOY
Mailing Address - State:PA
Mailing Address - Zip Code:17552
Mailing Address - Country:US
Mailing Address - Phone:717-653-1990
Mailing Address - Fax:
Practice Address - Street 1:422 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552
Practice Address - Country:US
Practice Address - Phone:717-653-1990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025952-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty