Provider Demographics
NPI:1750866273
Name:IE DENTAL SERVICES PC
Entity Type:Organization
Organization Name:IE DENTAL SERVICES PC
Other - Org Name:YARDLEY DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PURVI
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-504-2400
Mailing Address - Street 1:501 FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5512
Mailing Address - Country:US
Mailing Address - Phone:215-504-2400
Mailing Address - Fax:215-504-7450
Practice Address - Street 1:501 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5512
Practice Address - Country:US
Practice Address - Phone:215-504-2400
Practice Address - Fax:215-504-7450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IE DENTAL SERVICES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-01
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment