Provider Demographics
NPI:1578809224
Name:AMERICAN DENTAL EXCELLENCE INC.
Entity Type:Organization
Organization Name:AMERICAN DENTAL EXCELLENCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEYUR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATOLIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:484-973-6567
Mailing Address - Street 1:292 W RIDGE PIKE
Mailing Address - Street 2:BUILDING B 2ND FLOOR
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468-3716
Mailing Address - Country:US
Mailing Address - Phone:484-973-6567
Mailing Address - Fax:
Practice Address - Street 1:292 W RIDGE PIKE
Practice Address - Street 2:BUILDING B 2ND FLOOR
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-3716
Practice Address - Country:US
Practice Address - Phone:484-973-6567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0374741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty