Provider Demographics
NPI:1477689495
Name:DESANTIS, JOSEPH FELIX (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FELIX
Last Name:DESANTIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 BALTIMORE PIKE
Mailing Address - Street 2:SUITE # 10
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-7361
Mailing Address - Country:US
Mailing Address - Phone:610-358-5002
Mailing Address - Fax:610-358-5023
Practice Address - Street 1:1290 BALTIMORE PIKE
Practice Address - Street 2:SUITE # 10
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-7361
Practice Address - Country:US
Practice Address - Phone:610-358-5002
Practice Address - Fax:610-358-5023
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023512L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist