Provider Demographics
NPI:1932126950
Name:ENDODONTICS LIMITED PC
Entity Type:Organization
Organization Name:ENDODONTICS LIMITED PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-969-1222
Mailing Address - Street 1:2137 WELSH ROAD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115
Mailing Address - Country:US
Mailing Address - Phone:215-969-1222
Mailing Address - Fax:215-969-1233
Practice Address - Street 1:2137 WELSH ROAD
Practice Address - Street 2:SUITE 3A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115
Practice Address - Country:US
Practice Address - Phone:215-969-1222
Practice Address - Fax:215-969-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty