Provider Demographics
NPI:1033488291
Name:TICKLE TOOTH HOLDINGS P.C.
Entity Type:Organization
Organization Name:TICKLE TOOTH HOLDINGS P.C.
Other - Org Name:EXTON PEDIATRIC AND ADOLESCENT DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-363-8872
Mailing Address - Street 1:2217 BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-4013
Mailing Address - Country:US
Mailing Address - Phone:610-444-1331
Mailing Address - Fax:
Practice Address - Street 1:235 S POTTSTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2747
Practice Address - Country:US
Practice Address - Phone:610-363-8872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-17
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DS030525L1223G0001X
PADS030525L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty