Provider Demographics
NPI:1912339607
Name:GENERAL DENTISTRY NUMBER ONE PC
Entity Type:Organization
Organization Name:GENERAL DENTISTRY NUMBER ONE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ILYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BABINER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-698-2710
Mailing Address - Street 1:332 BUSTLETON PIKE
Mailing Address - Street 2:REAR SUITE
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7856
Mailing Address - Country:US
Mailing Address - Phone:215-698-2710
Mailing Address - Fax:
Practice Address - Street 1:332 BUSTLETON PIKE
Practice Address - Street 2:REAR SUITE
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-7856
Practice Address - Country:US
Practice Address - Phone:215-698-2710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031068L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty