Provider Demographics
NPI:1649429598
Name:ADVANCED & COMFORT DENTISTRY
Entity type:Organization
Organization Name:ADVANCED & COMFORT DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CK
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAGAT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:610-432-1200
Mailing Address - Street 1:3655 MUNICIPAL DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-2923
Mailing Address - Country:US
Mailing Address - Phone:610-432-1200
Mailing Address - Fax:610-432-8150
Practice Address - Street 1:3655 MUNICIPAL DR
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-2923
Practice Address - Country:US
Practice Address - Phone:610-432-1200
Practice Address - Fax:610-432-8150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA297281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherDENTAL OFFICE