Provider Demographics
NPI:1497026660
Name:EUNSON FAMILY AND COSMETIC DENTISTRY
Entity Type:Organization
Organization Name:EUNSON FAMILY AND COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:EUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-558-1977
Mailing Address - Street 1:131 COMMONS CT
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9724
Mailing Address - Country:US
Mailing Address - Phone:610-558-1977
Mailing Address - Fax:610-558-4980
Practice Address - Street 1:131 COMMONS CT
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9724
Practice Address - Country:US
Practice Address - Phone:610-558-1977
Practice Address - Fax:610-558-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036977261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental