Provider Demographics
NPI:1710249131
Name:VALLEY PROSTHODONTICS, PC
Entity Type:Organization
Organization Name:VALLEY PROSTHODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-776-7760
Mailing Address - Street 1:1259 S CEDAR CREST BLVD
Mailing Address - Street 2:STE 206
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6372
Mailing Address - Country:US
Mailing Address - Phone:610-776-7760
Mailing Address - Fax:610-776-7234
Practice Address - Street 1:1259 S CEDAR CREST BLVD
Practice Address - Street 2:STE 206
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6372
Practice Address - Country:US
Practice Address - Phone:610-776-7760
Practice Address - Fax:610-776-7234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025349L1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty