Provider Demographics
NPI:1437582590
Name:HOORFAR DENTAL GROUP-WILLOW GROVE-SPRING HOUSE LLC
Entity Type:Organization
Organization Name:HOORFAR DENTAL GROUP-WILLOW GROVE-SPRING HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MERSAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOORFAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-256-3666
Mailing Address - Street 1:801 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2024
Mailing Address - Country:US
Mailing Address - Phone:215-659-3334
Mailing Address - Fax:215-659-3585
Practice Address - Street 1:801 EASTON RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2024
Practice Address - Country:US
Practice Address - Phone:215-659-3334
Practice Address - Fax:215-659-3585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029513L261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center