Provider Demographics
NPI:1336213065
Name:EXCLUSIVELY ENDODONTICS PA
Entity Type:Organization
Organization Name:EXCLUSIVELY ENDODONTICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENEDICT
Authorized Official - Middle Name:
Authorized Official - Last Name:BACHSTEIN
Authorized Official - Suffix:I
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-429-7811
Mailing Address - Street 1:401 KINGS HWY S
Mailing Address - Street 2:STE 3A
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034
Mailing Address - Country:US
Mailing Address - Phone:856-429-7811
Mailing Address - Fax:856-216-8194
Practice Address - Street 1:401 KINGS HWY S
Practice Address - Street 2:STE 3A
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034
Practice Address - Country:US
Practice Address - Phone:856-429-7811
Practice Address - Fax:856-216-8194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty