Provider Demographics
NPI:1457376477
Name:SILVERDALE DENTISTRY
Entity Type:Organization
Organization Name:SILVERDALE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:KRATCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-453-5212
Mailing Address - Street 1:1000 E WALNUT ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-5444
Mailing Address - Country:US
Mailing Address - Phone:215-453-5212
Mailing Address - Fax:215-453-9212
Practice Address - Street 1:1000 E WALNUT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-5444
Practice Address - Country:US
Practice Address - Phone:215-453-5212
Practice Address - Fax:215-453-9212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031486L261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental