Provider Demographics
NPI:1275133811
Name:4K FAMILY DENTAL
Entity Type:Organization
Organization Name:4K FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVESH
Authorized Official - Middle Name:P
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-900-0576
Mailing Address - Street 1:1373 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18974-6136
Mailing Address - Country:US
Mailing Address - Phone:215-756-6021
Mailing Address - Fax:
Practice Address - Street 1:12109 CENTENNIAL STA
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-5488
Practice Address - Country:US
Practice Address - Phone:215-443-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty