Provider Demographics
NPI:1497408553
Name:DELAWARE COUNTY DENTAL, LLC
Entity Type:Organization
Organization Name:DELAWARE COUNTY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMAGNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-832-1599
Mailing Address - Street 1:92 OVERLOOK CIR
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-2250
Mailing Address - Country:US
Mailing Address - Phone:484-832-1599
Mailing Address - Fax:
Practice Address - Street 1:92 OVERLOOK CIR
Practice Address - Street 2:
Practice Address - City:GARNET VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19060-2250
Practice Address - Country:US
Practice Address - Phone:484-832-1599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1063941623OtherNPI