Provider Demographics
NPI:1477763373
Name:JOHN C. W. WORSLEY, JR. P.C.
Entity Type:Organization
Organization Name:JOHN C. W. WORSLEY, JR. P.C.
Other - Org Name:JOHN C. W. WORSLEY, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C W
Authorized Official - Last Name:WORSLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-867-7112
Mailing Address - Street 1:920 N NEW ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2714
Mailing Address - Country:US
Mailing Address - Phone:610-867-7112
Mailing Address - Fax:610-868-3435
Practice Address - Street 1:920 N NEW ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-2714
Practice Address - Country:US
Practice Address - Phone:610-867-7112
Practice Address - Fax:610-868-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-019070-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty