Provider Demographics
NPI:1235143116
Name:THEODORE J. BLINDER DDS ASSO
Entity Type:Organization
Organization Name:THEODORE J. BLINDER DDS ASSO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BLINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-446-2221
Mailing Address - Street 1:2427 W DARBY RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-1422
Mailing Address - Country:US
Mailing Address - Phone:610-446-4596
Mailing Address - Fax:610-449-1863
Practice Address - Street 1:2427 W DARBY RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-1422
Practice Address - Country:US
Practice Address - Phone:610-446-4596
Practice Address - Fax:610-449-1863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty