Schuylkill Mall Dental

NPI #1396969093 in Frackville, Pennsylvania

Provider Information

NPI Number: 1396969093
Entity Type: Organization
Organization Name: Schuylkill Mall Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 12, 2007
Last Updated: Jun 20, 2008

Practice Location

Address: SCHUYLKILL MALL DENTAL
Address 2: ROUTE 61 AT INTERSTATE 81
City: Frackville
State: Pennsylvania
ZIP Code: 18219
Phone: (570) 874-3714

Authorized Official

Name: DR. RAYMOND EDWARD HISCHE, DMD
Title: OWNER
Phone: (570) 874-3714

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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