Provider Demographics
NPI:1639380033
Name:JOSEPH J HAVRILLA DDS INC
Entity Type:Organization
Organization Name:JOSEPH J HAVRILLA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAVRILLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-328-9608
Mailing Address - Street 1:905 W SPROUL RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-1254
Mailing Address - Country:US
Mailing Address - Phone:610-328-9608
Mailing Address - Fax:610-328-5549
Practice Address - Street 1:905 W SPROUL RD
Practice Address - Street 2:SUITE 108
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-1254
Practice Address - Country:US
Practice Address - Phone:610-328-9608
Practice Address - Fax:610-328-5549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024390-L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty