Provider Demographics
NPI:1639298151
Name:GWYNEDD ENDODONTIC ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:GWYNEDD ENDODONTIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-643-8300
Mailing Address - Street 1:1364 WELSH RD
Mailing Address - Street 2:SUITE D-2
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1913
Mailing Address - Country:US
Mailing Address - Phone:215-643-8300
Mailing Address - Fax:215-643-4141
Practice Address - Street 1:1364 WELSH RD
Practice Address - Street 2:SUITE D-2
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1913
Practice Address - Country:US
Practice Address - Phone:215-643-8300
Practice Address - Fax:215-643-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026600L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty