Provider Demographics
NPI:1619013364
Name:NARBERTH DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:NARBERTH DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:OLIVER
Authorized Official - Last Name:MALTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-667-3631
Mailing Address - Street 1:113 N ESSEX AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2205
Mailing Address - Country:US
Mailing Address - Phone:610-667-3631
Mailing Address - Fax:610-667-4504
Practice Address - Street 1:113 N ESSEX AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2205
Practice Address - Country:US
Practice Address - Phone:610-667-3631
Practice Address - Fax:610-667-4504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022365L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty