Provider Demographics
NPI:1740417369
Name:STAR CARE DENTAL
Entity Type:Organization
Organization Name:STAR CARE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEMA
Authorized Official - Middle Name:R
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-358-5151
Mailing Address - Street 1:1102 BALTIMORE PIKE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1058
Mailing Address - Country:US
Mailing Address - Phone:610-358-5151
Mailing Address - Fax:
Practice Address - Street 1:1102 BALTIMORE PIKE
Practice Address - Street 2:SUITE 203
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1058
Practice Address - Country:US
Practice Address - Phone:610-358-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035582122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty