Provider Demographics
NPI:1710029392
Name:DOYLESTOWN DENTAL SERVICES INC
Entity Type:Organization
Organization Name:DOYLESTOWN DENTAL SERVICES INC
Other - Org Name:DOYLESTOWN DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:CAVANAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-345-1155
Mailing Address - Street 1:800 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902
Mailing Address - Country:US
Mailing Address - Phone:215-345-1155
Mailing Address - Fax:215-345-9090
Practice Address - Street 1:800 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902
Practice Address - Country:US
Practice Address - Phone:215-345-1155
Practice Address - Fax:215-345-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0163571223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty