Provider Demographics
NPI:1760581581
Name:READING ORAL SURGERY GROUP, LTD
Entity Type:Organization
Organization Name:READING ORAL SURGERY GROUP, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-777-7646
Mailing Address - Street 1:517 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-1364
Mailing Address - Country:US
Mailing Address - Phone:610-777-7646
Mailing Address - Fax:610-777-7570
Practice Address - Street 1:517 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-1364
Practice Address - Country:US
Practice Address - Phone:610-777-7646
Practice Address - Fax:610-777-7570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005247430001Medicaid
PA039397OtherHIGHMARK BLUE SHIELD
PA02979300OtherCAPITAL BLUE CROSS
PA0005247430002Medicaid
PA18602OtherHEALTH AM/HEALTH ASSURANC
PA18602OtherHEALTH AM/HEALTH ASSURANC
PA039397OtherHIGHMARK BLUE SHIELD