Provider Demographics
NPI:1740208198
Name:DEL VAL DENTAL IMAGING, LLC
Entity type:Organization
Organization Name:DEL VAL DENTAL IMAGING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYRENA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DEECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-855-5310
Mailing Address - Street 1:2100 N BROAD ST
Mailing Address - Street 2:STE 205
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1052
Mailing Address - Country:US
Mailing Address - Phone:215-855-5310
Mailing Address - Fax:
Practice Address - Street 1:2100 N BROAD ST
Practice Address - Street 2:STE 205
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1052
Practice Address - Country:US
Practice Address - Phone:215-855-5310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed TomographyGroup - Single Specialty