Provider Demographics
NPI:1033284799
Name:DENTAL CHOICE PA
Entity Type:Organization
Organization Name:DENTAL CHOICE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:MACE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-822-4310
Mailing Address - Street 1:400 DUTCHMANS LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3312
Mailing Address - Country:US
Mailing Address - Phone:410-822-4310
Mailing Address - Fax:410-822-3196
Practice Address - Street 1:400 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3312
Practice Address - Country:US
Practice Address - Phone:410-822-4310
Practice Address - Fax:410-822-3196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty