Provider Demographics
NPI:1225368012
Name:DOYLESTOWN TOWNSHIP DENTAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DOYLESTOWN TOWNSHIP DENTAL ASSOCIATES, LLC
Other - Org Name:SIMPLY BEAUTIFUL SMILES OF DOYLESTOWN
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:LUDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-348-4494
Mailing Address - Street 1:812 NORTH EASTON RD.
Mailing Address - Street 2:SUITE#8
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-1007
Mailing Address - Country:US
Mailing Address - Phone:215-348-4494
Mailing Address - Fax:267-277-3467
Practice Address - Street 1:812 N EASTON RD
Practice Address - Street 2:SUITE #8
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-1063
Practice Address - Country:US
Practice Address - Phone:215-348-4494
Practice Address - Fax:267-277-3467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty