Provider Demographics
NPI:1336299007
Name:ORTHODONTIC ASSOCIATES OF DELAWARE VALLEY
Entity Type:Organization
Organization Name:ORTHODONTIC ASSOCIATES OF DELAWARE VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:610-459-2545
Mailing Address - Street 1:101 DUTTON ST
Mailing Address - Street 2:
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-2308
Mailing Address - Country:US
Mailing Address - Phone:610-521-2222
Mailing Address - Fax:610-521-4274
Practice Address - Street 1:3920 PYLE RD
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-8934
Practice Address - Country:US
Practice Address - Phone:610-459-2545
Practice Address - Fax:610-459-8876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty