Provider Demographics
NPI:1780239228
Name:HATBORO DENTAL & SPECIALTY LLC
Entity type:Organization
Organization Name:HATBORO DENTAL & SPECIALTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-443-5400
Mailing Address - Street 1:122 N YORK RD STE 2
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2622
Mailing Address - Country:US
Mailing Address - Phone:215-443-5400
Mailing Address - Fax:215-957-0334
Practice Address - Street 1:122 N YORK RD STE 2
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-2622
Practice Address - Country:US
Practice Address - Phone:215-443-5400
Practice Address - Fax:215-957-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty