Provider Demographics
NPI:1336862176
Name:DENTAL IMPLANT STUDIO OF MONTGOMERY PC
Entity Type:Organization
Organization Name:DENTAL IMPLANT STUDIO OF MONTGOMERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DHANANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-963-4766
Mailing Address - Street 1:2489 WELLINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-1489
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2874 RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-1590
Practice Address - Country:US
Practice Address - Phone:484-963-4766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental