Provider Demographics
NPI:1164665030
Name:AMERICAN DENTAL CARE,LLC
Entity Type:Organization
Organization Name:AMERICAN DENTAL CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAFULCHANDRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:484-494-3300
Mailing Address - Street 1:875 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-2105
Mailing Address - Country:US
Mailing Address - Phone:484-494-3300
Mailing Address - Fax:484-494-5738
Practice Address - Street 1:875 MAIN ST
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-2105
Practice Address - Country:US
Practice Address - Phone:484-494-3300
Practice Address - Fax:484-494-5738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-020804-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty