Provider Demographics
NPI:1053553800
Name:BOORE, JESSICA L (RDH)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:BOORE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:DUNBAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:116 S GEORGE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-1474
Mailing Address - Country:US
Mailing Address - Phone:717-846-5846
Mailing Address - Fax:717-854-0377
Practice Address - Street 1:116 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-1474
Practice Address - Country:US
Practice Address - Phone:717-845-8617
Practice Address - Fax:717-718-1317
Is Sole Proprietor?:No
Enumeration Date:2009-03-25
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH069972124Q00000X
PAPHDH000381124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist