Provider Demographics
NPI:1871751826
Name:NEW HOLLAND DENTAL ASSOCIATES PC
Entity type:Organization
Organization Name:NEW HOLLAND DENTAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SRUJANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEELAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-293-8696
Mailing Address - Street 1:792 NEW HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2137
Mailing Address - Country:US
Mailing Address - Phone:717-293-8696
Mailing Address - Fax:
Practice Address - Street 1:792 NEW HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2137
Practice Address - Country:US
Practice Address - Phone:717-293-8696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0353511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018603500001Medicaid