Provider Demographics
NPI:1497323992
Name:SPECIAL NEEDS DENTISTRY OF PA
Entity Type:Organization
Organization Name:SPECIAL NEEDS DENTISTRY OF PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-384-6178
Mailing Address - Street 1:80 W WELSH POOL RD STE 202N
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1234
Mailing Address - Country:US
Mailing Address - Phone:610-524-8600
Mailing Address - Fax:
Practice Address - Street 1:80 W WELSH POOL RD STE 202N
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1234
Practice Address - Country:US
Practice Address - Phone:610-524-8600
Practice Address - Fax:610-524-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-12
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty