Provider Demographics
NPI:1235276296
Name:MAIN LINE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:MAIN LINE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL FOR ORGANIZATION
Authorized Official - Prefix:DR
Authorized Official - First Name:L.
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-525-2311
Mailing Address - Street 1:931 E HAVERFORD RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3838
Mailing Address - Country:US
Mailing Address - Phone:610-525-2311
Mailing Address - Fax:
Practice Address - Street 1:931 E HAVERFORD RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3838
Practice Address - Country:US
Practice Address - Phone:610-525-2311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty