1063476737 NPI number — CRAIG LAHAR DMD ORAL & MAXILLOFACIAL SURGERY PC

Table of content: (NPI 1063476737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063476737 NPI number — CRAIG LAHAR DMD ORAL & MAXILLOFACIAL SURGERY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRAIG LAHAR DMD ORAL & MAXILLOFACIAL SURGERY PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063476737
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 CUMBERLAND PARKWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MECHANICSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-697-6020
Provider Business Mailing Address Fax Number:
717-697-0263

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 CUMBERLAND PARKWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-697-6020
Provider Business Practice Location Address Fax Number:
717-697-0263
Provider Enumeration Date:
04/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAHAR
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
717-697-6020

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DS027134L . This is a "LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: DA027134A . This is a "LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".