Provider Demographics
NPI:1124423702
Name:DOYLESTOWN FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:DOYLESTOWN FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:JACQUES
Authorized Official - Last Name:BOTES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-909-4369
Mailing Address - Street 1:10 S CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4220
Mailing Address - Country:US
Mailing Address - Phone:215-345-7700
Mailing Address - Fax:215-230-4978
Practice Address - Street 1:10 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4220
Practice Address - Country:US
Practice Address - Phone:215-345-7700
Practice Address - Fax:215-230-4978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-25
Last Update Date:2014-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0395381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty