Provider Demographics
NPI:1801836275
Name:ENDODONTIC ASSOCIATES LTD.
Entity Type:Organization
Organization Name:ENDODONTIC ASSOCIATES LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:GRANITE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-543-2288
Mailing Address - Street 1:1050 BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2853
Mailing Address - Country:US
Mailing Address - Phone:610-543-2288
Mailing Address - Fax:610-543-3399
Practice Address - Street 1:1050 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2853
Practice Address - Country:US
Practice Address - Phone:610-543-2288
Practice Address - Fax:610-543-3399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty