Provider Demographics
NPI:1336470137
Name:NORWOOD FAMILY DENTISTRY
Entity Type:Organization
Organization Name:NORWOOD FAMILY DENTISTRY
Other - Org Name:CENTER FOR FAMILY & COSMETIC DENTISTRY AT NORWOOD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DINESH
Authorized Official - Middle Name:S
Authorized Official - Last Name:TEWARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-457-5671
Mailing Address - Street 1:7 W WINONA AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19074-1403
Mailing Address - Country:US
Mailing Address - Phone:610-532-0221
Mailing Address - Fax:610-532-4070
Practice Address - Street 1:7 W WINONA AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:PA
Practice Address - Zip Code:19074-1403
Practice Address - Country:US
Practice Address - Phone:610-532-0221
Practice Address - Fax:610-532-4070
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DREXEL HILL FAMILY DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0 35539122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty