Provider Demographics
NPI:1346306149
Name:AJS DENTAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:AJS DENTAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:RATHFON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-282-4581
Mailing Address - Street 1:1767 N MAIN STREET EXT
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1327
Mailing Address - Country:US
Mailing Address - Phone:724-282-4581
Mailing Address - Fax:724-283-1432
Practice Address - Street 1:1767 N MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1327
Practice Address - Country:US
Practice Address - Phone:724-282-4581
Practice Address - Fax:724-283-1432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019441L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty