Provider Demographics
NPI:1518020668
Name:ALL FAMILY DENTAL CARE,INC
Entity Type:Organization
Organization Name:ALL FAMILY DENTAL CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JYOTI
Authorized Official - Middle Name:
Authorized Official - Last Name:DESHMANE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-222-8189
Mailing Address - Street 1:9 CAMELOT WAY
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2910
Mailing Address - Country:US
Mailing Address - Phone:610-222-8189
Mailing Address - Fax:610-222-8121
Practice Address - Street 1:2012 BRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:SKIPPACK
Practice Address - State:PA
Practice Address - Zip Code:19474
Practice Address - Country:US
Practice Address - Phone:610-222-8189
Practice Address - Fax:610-222-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028689L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA784857OtherUCCI
PA000000262309Medicaid
PA1926Medicaid