Provider Demographics
NPI:1073752747
Name:NASE FAMILY DENTAL, LLC
Entity Type:Organization
Organization Name:NASE FAMILY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:NASE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-368-5105
Mailing Address - Street 1:920 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2351
Mailing Address - Country:US
Mailing Address - Phone:215-368-5105
Mailing Address - Fax:215-368-7020
Practice Address - Street 1:920 N BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2351
Practice Address - Country:US
Practice Address - Phone:215-368-5105
Practice Address - Fax:215-368-7020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA027675122300000X, 261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Single Specialty