Provider Demographics
NPI:1790462661
Name:PENNRIDGE DENTAL ARTS PC
Entity Type:Organization
Organization Name:PENNRIDGE DENTAL ARTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONAK
Authorized Official - Middle Name:NANDKISHOR
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-547-2340
Mailing Address - Street 1:1635 N 5TH ST STE 2208
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-2208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1635 N 5TH ST STE 2208
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-2208
Practice Address - Country:US
Practice Address - Phone:215-257-4811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental