Provider Demographics
NPI:1114038486
Name:CHESTER COUNTY ENDODONTICS-NORTH
Entity Type:Organization
Organization Name:CHESTER COUNTY ENDODONTICS-NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-692-3990
Mailing Address - Street 1:795 E MARSHALL ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4400
Mailing Address - Country:US
Mailing Address - Phone:610-692-3990
Mailing Address - Fax:610-436-4881
Practice Address - Street 1:795 E MARSHALL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4400
Practice Address - Country:US
Practice Address - Phone:610-692-3990
Practice Address - Fax:610-436-4881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-018600L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty