Provider Demographics
NPI:1619755675
Name:SP DENTAL CELEBRATIONS PC
Entity Type:Organization
Organization Name:SP DENTAL CELEBRATIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUMIT
Authorized Official - Middle Name:N
Authorized Official - Last Name:MORADIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-470-7323
Mailing Address - Street 1:2012 BRIDGE RD
Mailing Address - Street 2:PO BOX 137
Mailing Address - City:SKIPPACK
Mailing Address - State:PA
Mailing Address - Zip Code:19474
Mailing Address - Country:US
Mailing Address - Phone:610-222-8189
Mailing Address - Fax:610-222-8121
Practice Address - Street 1:2012 BRIDGE RD
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?:Yes
Parent Organization LBN:SP DENTAL CELEBRATIONS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental