Provider Demographics
NPI:1639365794
Name:WAYNE DENTAL CARE
Entity Type:Organization
Organization Name:WAYNE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-293-1227
Mailing Address - Street 1:295 OLD EAGLE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2609
Mailing Address - Country:US
Mailing Address - Phone:610-293-1227
Mailing Address - Fax:610-688-1896
Practice Address - Street 1:295 OLD EAGLE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-2609
Practice Address - Country:US
Practice Address - Phone:610-293-1227
Practice Address - Fax:610-688-1896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025722L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty