Provider Demographics
NPI:1245326024
Name:BACHSTEIN, THOMAS KARL (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KARL
Last Name:BACHSTEIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 W CHESTER PIKE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4294
Mailing Address - Country:US
Mailing Address - Phone:610-353-0753
Mailing Address - Fax:610-353-5396
Practice Address - Street 1:3475 W CHESTER PIKE
Practice Address - Street 2:SUITE 230
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4294
Practice Address - Country:US
Practice Address - Phone:610-353-0753
Practice Address - Fax:610-353-5396
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030932-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice