Provider Demographics
NPI:1891210894
Name:JOSEPH F. DESANTIS,D.M.D. AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:JOSEPH F. DESANTIS,D.M.D. AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-358-5002
Mailing Address - Street 1:1290 BALTIMORE PIKE STE 10
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-7361
Mailing Address - Country:US
Mailing Address - Phone:610-358-5002
Mailing Address - Fax:610-358-5023
Practice Address - Street 1:1290 BALTIMORE PIKE STE 10
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-7361
Practice Address - Country:US
Practice Address - Phone:610-358-5002
Practice Address - Fax:610-358-5023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023512L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty