Provider Demographics
NPI:1356899637
Name:A-FAMILY DENTAL CARE CENTER P.C.
Entity type:Organization
Organization Name:A-FAMILY DENTAL CARE CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-631-3400
Mailing Address - Street 1:2030 W MAIN ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-6003
Mailing Address - Country:US
Mailing Address - Phone:610-631-3400
Mailing Address - Fax:610-631-3422
Practice Address - Street 1:2030 W MAIN ST
Practice Address - Street 2:SUITE 9
Practice Address - City:JEFFERSONVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-6003
Practice Address - Country:US
Practice Address - Phone:610-631-3400
Practice Address - Fax:610-631-3422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030757L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty