Provider Demographics
NPI:1265658280
Name:PRAFULL M DOSHI, D.D.S. P.C.
Entity Type:Organization
Organization Name:PRAFULL M DOSHI, D.D.S. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAFULL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-926-9300
Mailing Address - Street 1:1032 PARK RD
Mailing Address - Street 2:
Mailing Address - City:BLANDON
Mailing Address - State:PA
Mailing Address - Zip Code:19510-9558
Mailing Address - Country:US
Mailing Address - Phone:610-926-9300
Mailing Address - Fax:610-926-8622
Practice Address - Street 1:1032 PARK RD
Practice Address - Street 2:
Practice Address - City:BLANDON
Practice Address - State:PA
Practice Address - Zip Code:19510-9558
Practice Address - Country:US
Practice Address - Phone:610-926-9300
Practice Address - Fax:610-926-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO19781-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000044787OtherDENTAL BENEFIT PROVIDERS
PA0005419191OtherAETNA
1313837OtherUNITED CONCORDIA
PA000000190326OtherMED ASST UNISON
PA9184421OtherMEDICAL ASSISTANCE (DORAL
PA=========OtherTAX ID