Provider Demographics
NPI:1083850416
Name:WEST CHESTER ENDODNTICS, PC
Entity Type:Organization
Organization Name:WEST CHESTER ENDODNTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:KRATCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-431-7025
Mailing Address - Street 1:606 E MARSHALL ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4467
Mailing Address - Country:US
Mailing Address - Phone:610-431-7025
Mailing Address - Fax:610-431-7027
Practice Address - Street 1:606 E MARSHALL ST
Practice Address - Street 2:SUITE 204
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4467
Practice Address - Country:US
Practice Address - Phone:610-431-7025
Practice Address - Fax:610-431-7027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027045L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty