| NPI | 1285301390 |
|---|---|
| Doing Business As | FRESHDENTAL HARRISBURG |
| Entity Type | Organization |
| Authorized Contact | RICHARD B VELAZQUE Director Of Implementation 704-516-0275 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2021-08-26 |