Provider Demographics
NPI:1437784238
Name:ALIGNED DENTAL OF WELLSBORO, PC
Entity type:Organization
Organization Name:ALIGNED DENTAL OF WELLSBORO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-577-3900
Mailing Address - Street 1:300 W CHESTNUT ST STE 205
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1987
Mailing Address - Country:US
Mailing Address - Phone:484-577-3900
Mailing Address - Fax:
Practice Address - Street 1:11671 ROUTE 6
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-6750
Practice Address - Country:US
Practice Address - Phone:570-724-2542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty